title: Comparison of outcome in patients with cirrhosis and ascites following treatment with albumin or a synthetic colloid: a randomised controlled pilot trail.
abstract: BACKGROUND
  The question of which colloid (albumin or synthetic colloids) used for plasma expansion following paracentesis or other complications requiring fluid loading in patients with cirrhosis remains controversial.
  
  
  OBJECTIVE
  To compare outcome and hospital-related cost in patients with cirrhosis treated with 20% human albumin with those treated with a synthetic colloid (3.5% polygeline).
  
  
  METHODS
  The primary end point was occurrence of a first liver-related complication.
  
  
  RESULTS
  When the trial was prematurely discontinued because of safety concerns about bovine-derived products, 30 patients were assigned to receive albumin and 38 were assigned to receive a synthetic colloid. Sixty-three patients were included for ascites removal by paracentesis and five patients for ascites removal by paracentesis and renal impairment. The median time to first liver-related complication was not significantly longer in the albumin group (20 vs. 7 days). However, the total number of liver-related complications adjusted to a 100-day period was significantly lower in the albumin group. The median hospital cost for a 30-day period was significantly lower in the albumin group (1915 euros vs. 4612 euros).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'Hépatologie and INSERM Unité 481, Hôpital Beaujon, Clichy, France. rmoreau@bichat.inserm.fr
authors.forename: Richard
authors.initials: R
authors.lastname: Moreau
authors.forename: Dominique-Charles
authors.initials: DC
authors.lastname: Valla
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durand-Zaleski
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: François
authors.initials: F
authors.lastname: Durand
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Chaput
authors.forename: Innocenti
authors.initials: I
authors.lastname: Dadamessi
authors.forename: Christine
authors.initials: C
authors.lastname: Silvain
authors.forename: Corinne
authors.initials: C
authors.lastname: Bonny
authors.forename: Frédéric
authors.initials: F
authors.lastname: Oberti
authors.forename: Jérôme
authors.initials: J
authors.lastname: Gournay
authors.forename: Didier
authors.initials: D
authors.lastname: Lebrec
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Grouin
authors.forename: Eric
authors.initials: E
authors.lastname: Guémas
authors.forename: Dominique
authors.initials: D
authors.lastname: Golly
authors.forename: Bruno
authors.initials: B
authors.lastname: Padrazzi
authors.forename: Zéra
authors.initials: Z
authors.lastname: Tellier
mesh_terms: D000328:Adult; D000418:Albumins / Q000009:adverse effects / Q000627:therapeutic use*; D001201:Ascites / Q000473:pathology* / Q000628:therapy; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D019152:Paracentesis / Q000379:methods; D010865:Pilot Projects; D011097:Polygeline / Q000009:adverse effects / Q000627:therapeutic use*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D011097:Polygeline