The long-term use of albumin in decompensated cirrhosis represents a change in the classical paradigm for patient management and treatment.
This module examines the topic and addresses related research.
Key Takeaways
The long-term use of albumin in patients with decompensated cirrhosis aims to prevent and control the complications of the disease and modify its clinical course and patient survival.
Two important multicenter RCTs assessed long-term albumin administration: the ANSWER trial achieved a positive result on overall survival and incidence of major complications of cirrhosis, the MACHT trial did not obtain differences among patients treated or not with albumin.
The differences between the the ANSWER and the MACHT trials, in terms of amount of albumin administered, duration of treatment, and effects on serum albumin concentration, explain the different clinical results.
A significant increase in serum albumin concentration is needed to unveil the benefits of long-term treatment, which should aim to at least normalize serum albumin levels. An on-treatment value of about 4.0 g/dl seems to be associated with better outcomes.
As shown in a monocentric non-randomized trial, patients with refractory ascites can also benefit from long-term albumin administration.
