• Carla Cremonese, Frank Erhard Uschner, and Jonel Trebicka.
• Universitätsklinikum Frankfurt am Main - Medizinische Klinik I, Goethe-Universität Frankfurt am Main.
• Dtsch. Med. Wochenschr. 2020 Jun 1; 145 (11): 722-726.

AbstractThe recommended indications for short-term use of human albumin in patients with decompensated cirrhosis are the following: prevention of paracenteses induced circulatory dysfunction, treatment of hypovolemia, prevention of hepatorenal syndrome in high-risk patients with spontaneous bacterial peritonitis, as well as treatment of hepatorenal syndrome. Liver cirrhosis is associated with systemic inflammation, which is further increased in decompensated cirrhosis and acute-on-chronic liver failure. Besides its function as plasma expander, albumin is known to have pleiotropic non-oncotic properties. It serves as antioxidant, scavenging and provides immune-modulating and endothelium protective functions. Albumin treatment may be beneficial to prevent further decompensation and acute-on-chronic liver failure. Recent studies suggest, that long-term albumin administration in patients with cirrhosis and ascites improves survival, prevents complications, facilitates the management of ascites and reduces hospitalizations. Moreover, during infections albumin may prevent development of acute-on-chronic liver failure. Still, further studies are needed to confirm these disease-modifying effects of albumin, define its optimal dosage and administration schedule and detect patients who benefit most from albumin administration in different scenarios.© Georg Thieme Verlag KG Stuttgart · New York.

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