The use of human albumin in patients with cirrhosis: a European survey

Expert Rev Gastroenterol Hepatol. 2018 Jun;12(6):625-632. doi: 10.1080/17474124.2018.1460203. Epub 2018 Apr 4.

Abstract

Background: The administration of human albumin (HA) in patients with decompensated cirrhosis is still debated. The European Foundation for the Study of Chronic Liver Failure (EF-CLIF) promoted an online survey to assess its use across Europe.

Methods: Hepatologists were invited to participate to an electronic questionnaire based on multiple-choice questions divided in 6 different areas. A descriptive statistical analysis was performed to analyze the responses.

Results: One hundred-one hepatologists (36% non-EF-CLIF member), belonging to 86 centers (25% non-academic hospitals) completed the survey. The vast majority of participants prescribe HA for the evidence-based indications supported by international guidelines, while a proportion of them consider HA administration useful for other complications currently not supported by solid scientific evidence. Participants show a good level of knowledge about the non-oncotic properties of the molecule, while HA prescription does not appear to be restricted by health authorities in most centers, at least for the evidence-based indications.

Conclusions: The present survey indicates that hepatologists across Europe present adherence to international guidelines and highlights the areas where solid scientific data are awaited to achieve a more appropriate HA prescription in patients with decompensated cirrhosis.

Keywords: Cirrhosis; complication of cirrhosis; human albumin; non-oncotic properties; oncotic properties; survey.

MeSH terms

  • Europe
  • Evidence-Based Medicine / trends
  • Gastroenterologists / standards
  • Gastroenterologists / trends*
  • Guideline Adherence / trends
  • Health Care Surveys
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis / therapy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends*
  • Serum Albumin, Human / administration & dosage*
  • Serum Albumin, Human / adverse effects

Substances

  • Serum Albumin, Human