©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 8, 2016; 8(7): 345-354
Published online Mar 8, 2016. doi: 10.4254/wjh.v8.i7.345
Published online Mar 8, 2016. doi: 10.4254/wjh.v8.i7.345
Human albumin solution for patients with cirrhosis and acute on chronic liver failure: Beyond simple volume expansion
Christopher Valerio, Banwari Agarwal, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, London NW3 2QG, United Kingdom
Eleni Theocharidou, the Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital, Royal Free Hampstead NHS Trust and Institute of Liver and Digestive Health, University College London, London NW3 2QG, United Kingdom
Andrew Davenport, UCL Centre for Nephrology, Royal Free Hospital, London NW3 2QG, United Kingdom
Author contributions: Davenport A and Agarwal B devised the idea; Valerio C wrote the first draft; Theocharidou E revised the draft; all authors contributed to reviewing articles, editing, revising and preparing the manuscript for publication.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Correspondence to: Banwari Agarwal, MD, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, Pond Street, London NW3 2QG, United Kingdom. banwari.agarwal@nhs.net
Telephone: +44-20-77940500
Received: October 29, 2015
Peer-review started: November 3, 2015
First decision: November 30, 2015
Revised: December 22, 2015
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: March 8, 2016
Processing time: 126 Days and 7.2 Hours
Peer-review started: November 3, 2015
First decision: November 30, 2015
Revised: December 22, 2015
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: March 8, 2016
Processing time: 126 Days and 7.2 Hours
Core Tip
Core tip: Human serum albumin has several important functions beyond being the principal protein in plasma. In disease states, albumin levels may not only be low but there may also be functional hypoalbuminaemia. This may explain why human albumin solution is helpful in treating the complications of cirrhosis whereas its role (as a volume expander) in critical illness remains limited. However, in the presence of cirrhosis or acute liver failure the restoration of functional albumin may be beneficial, even in critically ill patients. This still needs to be addressed in clinical trials.