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Dig Liver Dis. 2016 Jan;48(1):4-15. doi: 10.1016/j.dld.2015.11.008.

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

Author information

1
Department of Medical and Surgical Sciences, University of Bologna, Italy. Electronic address: paolo.caraceni@unibo.it.
2
Department of Medicine, University of Padua, Italy.
3
Department of Transfusion Medicine and Hematology, Ospedale Alessandro Manzoni, Lecco, Italy.
4
Department of Medical and Surgical Sciences, University of Bologna, Italy.
5
Division of Gastroenterology and Hepatology, AOU Città della Salute e della Scienza, University of Turin, Italy.
6
Department of Clinical Medicine, "Sapienza" University of Rome, Italy.
7
Department of Internal Medicine, Policlinico IRCCS San Donato, University of Milan, Italy.
8
Italian National Blood Centre, National Institute of Health, Rome, Italy.
9
Immunohaematology and Transfusion Medicine Centre, Provincial Health Authority, Ragusa, Italy.
10
Transfusion Medicine Unit, University Hospital of Verona, Italy.
11
Transfusion Medicine and Immunohaematology Department of Bologna Metropolitan Area, Italy.
12
Immunohaematology and Transfusion Service, Aosta, Italy.
13
Italian National Blood Centre, National Institute of Health, Rome, Italy; Immunohaemathology and Transfusion Medicine Unit, AOU Città della Salute e della Scienza", Turin, Italy.
14
Transfusion Service, San Donà di Piave, Italy.

Abstract

The use of human albumin is common in hepatology since international scientific societies support its administration to treat or prevent severe complications of cirrhosis, such as the prevention of post-paracentesis circulatory dysfunction after large-volume paracentesis and renal failure induced by spontaneous bacterial peritonitis, and the treatment of hepatorenal syndrome in association with vasoconstrictors. However, these indications are often disregarded, mainly because the high cost of human albumin leads health authorities and hospital administrations to restrict its use. On the other hand, physicians often prescribe human albumin in patients with advanced cirrhosis for indications that are not supported by solid scientific evidence and/or are still under investigation in clinical trials. In order to implement appropriate prescription of human albumin and to avoid its futile use, the Italian Association for the Study of the Liver (AISF) and the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) nominated a panel of experts, who reviewed the available clinical literature and produced practical clinical recommendations for the use of human albumin in patients with cirrhosis.

KEYWORDS:

Ascites; Hepatorenal syndrome; Post-paracentesis circulatory dysfunction; Spontaneous bacterial peritonitis

PMID:
26802734
DOI:
10.1016/j.dld.2015.11.008
[Indexed for MEDLINE]

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