Comparison of outcome in patients with cirrhosis and ascites following treatment with albumin or a synthetic colloid:

Abstract

In patients with cirrhosis and ascites, human albumin appears to be more effective in preventing liver-related complications than synthetic colloid. This may be associated with decreased hospital costs.

Human Albumin in the Management of Complications of Liver Cirrhosis

“…Albumin was more eff ective than other plasma expanders (dextran-70 or polygeline) for the prevention of PPCD when more than 5 l of ascites were removed; however, the incidence of PPCD was similar when less than 5 l of ascites were tapped [18,19]. Moreover, use of albumin after largevolume paracentesis compared with alternative but cheaper plasma expanders appears to be more costeff ective because albumin post-paracentesis is associated with fewer liver-related complications within the fi rst month [20].…”

Pharmacological Therapy of Ascites

“…This finding was mainly attributed to the fact that the administration of albumin post-paracentesis is associated with a smaller number of liver-related complications within the first 30 days which leads to increased total health cost [56].…”

“…Nevertheless, albumin has higher efficacy than these other plasma expanders if in the case of removal of more than 5 L of ascetic fluid [44]. In spite of that, randomized trials did not show survival advantage in patients treated with albumin versus those treated with other plasma expanders [44,53,56]. To demonstrate survival benefit of albumin, larger trials are warranted.…”

AISF-SIMTI Position Paper: The appropriate use of albumin in patients with liver cirrhosis

“…Despite this greater efficacy in preventing PPCD, randomised trials have not shown differences in the survival of patients receiving HA compared with that of patients given alternative treatments 15,25,34 . However, a recent meta-analysis indicates that HA after largevolume paracentesis is significantly more effective than other treatments at reducing not only PPCD and hyponatraemia, but also mortality 35 .…”