title: Hypoalbuminemia in donors with twin-twin transfusion syndrome.
abstract: OBJECTIVE
  To estimate the differences in albumin levels between donors and recipients with twin-twin transfusion syndrome (TTTS).
  
  
  METHODS
  We performed a matched case-control study including twin pairs with TTTS treated conservatively (conservative group) or with fetoscopic laser surgery (laser group) and analyzed the albumin levels at birth in donor and recipient twins.
  
  
  RESULTS
  We included 18 twin pairs in the conservative group and 36 control twin pairs (laser group), matched for gestational age at birth. Median albumin levels in donor twins in the conservative group were significantly lower than in recipient twins, 25.0 versus 33.0 g/l, respectively (p = 0.001). In the laser group, albumin levels in donors and recipients were similar, 32.0 versus 32.0 g/l, respectively (p = 0.633). Hypoalbuminemia (albumin level <20 g/l) occurred in 22% (4/18) of donor twins in the conservative group.
  
  
  CONCLUSIONS
  Hypoalbuminemia occurs frequently in donor twins with TTTS treated conservatively. In TTTS treated with laser, donor twins have similar and normal albumin levels compared to recipients, confirming a successfully performed fetoscopic laser procedure.
authors.affiliation: Division of Neonatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Verbeek
authors.forename: J M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: C V
authors.initials: CV
authors.lastname: Hulzebos
authors.forename: D
authors.initials: D
authors.lastname: Oepkes
authors.forename: F J
authors.initials: FJ
authors.lastname: Walther
authors.forename: E
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D000046:Academic Medical Centers; D001782:Blood Donors; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005330:Fetofetal Transfusion / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D005332:Fetoscopy; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood* / Q000209:etiology; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D017075:Laser Coagulation; D009426:Netherlands; D011247:Pregnancy; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human; D012720:Severity of Illness Index
chemical_list: C422455:ALB protein, human; D012709:Serum Albumin; D000075462:Serum Albumin, Human