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Open Access 01-09-2020 | Hepatorenal Syndrome | Management of the Cirrhotic Patient (A Cardenas and P Tandon, Section Editors)

Hemodynamic and Systemic Effects of Albumin in Patients with Advanced Liver Disease

Authors: Manuel Tufoni, Maurizio Baldassarre, Giacomo Zaccherini, Agnese Antognoli, Paolo Caraceni

Published in: Current Hepatology Reports | Issue 3/2020

Abstract

Purpose of Review

Albumin administration is recommended to prevent or treat specific complications of decompensated cirrhosis based on its capacity to expand plasma volume. However, the molecule also has many other biological properties that are unrelated to the oncotic activity. The purpose of this review is to examine the hemodynamic and systemic effects of albumin administration in patients with decompensated cirrhosis.

Recent Findings

Besides plasma expansion, albumin appears to act against inflammation, facilitate immunocompetence, and improve cardiac and endothelial function, thus antagonizing critical steps in the pathophysiological cascade underlying decompensated cirrhosis.

Summary

Increasing knowledge of the pathophysiological mechanisms of the disease, as well the pleiotropic properties of the molecule, provides the rationale for considering albumin as a multi-target disease-modifying agent in decompensated cirrhosis. Both oncotic and non-oncotic properties likely concur with the clinical benefits of long-term albumin administration recently demonstrated in these patients.

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Title: Hemodynamic and Systemic Effects of Albumin in Patients with Advanced Liver Disease
Authors: Manuel Tufoni
Maurizio Baldassarre
Giacomo Zaccherini
Agnese Antognoli
Paolo Caraceni
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Hepatorenal Syndrome
Ascites
Hepatorenal Syndrome
Published in: Current Hepatology Reports / Issue 3/2020
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00521-1

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