TY - JOUR
T1 - Use of albumin infusion for cirrhosis-related complications
T2 - An international position statement
AU - Bai, Zhaohui
AU - Méndez-Sánchez, Nahum
AU - Romeiro, Fernando Gomes
AU - Mancuso, Andrea
AU - Philips, Cyriac Abby
AU - Tacke, Frank
AU - Basaranoglu, Metin
AU - Primignani, Massimo
AU - Ibrahim, Mostafa
AU - Wong, Yu Jun
AU - Nery, Filipe Gaio
AU - Teschke, Rolf
AU - Ferreira, Carlos Noronha
AU - Muñoz, Alberto E.
AU - Pinyopornpanish, Kanokwan
AU - Thevenot, Thierry
AU - Singh, Shivaram Prasad
AU - Mohanty, Arpan
AU - Satapathy, Sanjaya K.
AU - Ridola, Lorenzo
AU - Maruyama, Hitoshi
AU - Cholongitas, Evangelos
AU - Levi Sandri, Giovanni Battista
AU - Yang, Li
AU - Shalimar,
AU - Yang, Yongping
AU - Villa, Erica
AU - Krag, Aleksander
AU - Wong, Florence
AU - Jalan, Rajiv
AU - O'Brien, Alastair
AU - Bernardi, Mauro
AU - Qi, Xingshun
AU - the Liver Cirrhosis-related Complications (LCC)-International Special Interest Group
N1 - Funding Information:
This work is partially funded by the Young and Middle-aged Scientific and Technological Innovation Talents Support Plan Project of Shenyang ( RC210011 ) and the Outstanding Youth Foundation of Liaoning Province ( 2022-YQ-07 ).pt
PY - 2023/8
Y1 - 2023/8
N2 - Background & Aims: Numerous studies have evaluated the role of human albumin (HA) in managing various liver cirrhosis-related complications. However, their conclusions remain partially controversial, probably because HA was evaluated in different settings, including indications, patient characteristics, and dosage and duration of therapy. Methods: Thirty-three investigators from 19 countries with expertise in the management of liver cirrhosis-related complications were invited to organise an International Special Interest Group. A three-round Delphi consensus process was conducted to complete the international position statement on the use of HA for treatment of liver cirrhosis-related complications. Results: Twelve clinically significant position statements were proposed. Short-term infusion of HA should be recommended for the management of hepatorenal syndrome, large volume paracentesis, and spontaneous bacterial peritonitis in liver cirrhosis. Its effects on the prevention or treatment of other liver cirrhosis-related complications should be further elucidated. Long-term HA administration can be considered in specific settings. Pulmonary oedema should be closely monitored as a potential adverse effect in cirrhotic patients receiving HA infusion. Conclusions: Based on the currently available evidence, the international position statement suggests the potential benefits of HA for the management of multiple liver cirrhosis-related complications and summarises its safety profile. However, its optimal timing and infusion strategy remain to be further elucidated. Impact and implications: Thirty-three investigators from 19 countries proposed 12 position statements on the use of human albumin (HA) infusion in liver cirrhosis-related complications. Based on current evidence, short-term HA infusion should be recommended for the management of HRS, LVP, and SBP; whereas, long-term HA administration can be considered in the setting where budget and logistical issues can be resolved. However, pulmonary oedema should be closely monitored in cirrhotic patients who receive HA infusion.
AB - Background & Aims: Numerous studies have evaluated the role of human albumin (HA) in managing various liver cirrhosis-related complications. However, their conclusions remain partially controversial, probably because HA was evaluated in different settings, including indications, patient characteristics, and dosage and duration of therapy. Methods: Thirty-three investigators from 19 countries with expertise in the management of liver cirrhosis-related complications were invited to organise an International Special Interest Group. A three-round Delphi consensus process was conducted to complete the international position statement on the use of HA for treatment of liver cirrhosis-related complications. Results: Twelve clinically significant position statements were proposed. Short-term infusion of HA should be recommended for the management of hepatorenal syndrome, large volume paracentesis, and spontaneous bacterial peritonitis in liver cirrhosis. Its effects on the prevention or treatment of other liver cirrhosis-related complications should be further elucidated. Long-term HA administration can be considered in specific settings. Pulmonary oedema should be closely monitored as a potential adverse effect in cirrhotic patients receiving HA infusion. Conclusions: Based on the currently available evidence, the international position statement suggests the potential benefits of HA for the management of multiple liver cirrhosis-related complications and summarises its safety profile. However, its optimal timing and infusion strategy remain to be further elucidated. Impact and implications: Thirty-three investigators from 19 countries proposed 12 position statements on the use of human albumin (HA) infusion in liver cirrhosis-related complications. Based on current evidence, short-term HA infusion should be recommended for the management of HRS, LVP, and SBP; whereas, long-term HA administration can be considered in the setting where budget and logistical issues can be resolved. However, pulmonary oedema should be closely monitored in cirrhotic patients who receive HA infusion.
KW - Decompensated
KW - Human albumin
KW - Kidney injury
KW - Liver failure
KW - Management
KW - Portal hypertension
KW - Sepsis
U2 - 10.1016/j.jhepr.2023.100785
DO - 10.1016/j.jhepr.2023.100785
M3 - Journal article
C2 - 37456673
AN - SCOPUS:85165027587
SN - 2589-5559
VL - 5
JO - JHEP Reports
JF - JHEP Reports
IS - 8
M1 - 100785
ER -