title: AISF-SIMTI position paper: the appropriate use of albumin in patients with liver cirrhosis.
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.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Caraceni
authors.affiliation: Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.affiliation: Department of Transfusion Medicine and Hematology, "Alessandro Manzoni" Hospital, Lecco, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Prati
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.affiliation: Italian National Blood Centre, National Institute of Health, Rome, Italy.
authors.forename: Giancarlo M
authors.initials: GM
authors.lastname: Liumbruno
authors.affiliation: Immunohaematology and Transfusion Medicine Centre, Provincial Health Authority n. 7, Ragusa - "R. Guzzardi" Hospital, Vittoria, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bennardello
authors.affiliation: Transfusion Medicine Unit, University Hospital of Verona, Verona, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Piccoli
authors.affiliation: Transfusion Medicine and Immunohaematology Department of Bologna Metropolitan Area, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Velati
mesh_terms: D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D008958:Models, Molecular; D012709:Serum Albumin / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*
chemical_list: D012709:Serum Albumin
references.citation: J Hepatol. 2010 Sep;53(3):397-417
references.pmid: 20633946
references.citation: J Hepatol. 1994 Feb;20(2):282-8
references.pmid: 7516361
references.citation: Postgrad Med J. 2009 Jan;85(999):44-54
references.pmid: 19240290
references.citation: Gut. 2012 Sep;61(9):1371-2
references.pmid: 22217507
references.citation: Gut. 1990 Feb;31(2):204-7
references.pmid: 2311979
references.citation: Hepatology. 2009 Aug;50(2):555-64
references.pmid: 19642174
references.citation: Hepatology. 2012 Apr;55(4):1172-81
references.pmid: 22095893
references.citation: J Hepatol. 2013 Dec;59(6):1184-92
references.pmid: 23872605
references.citation: Gut. 2015 Apr;64(4):531-7
references.pmid: 25631669
references.citation: J Gastroenterol Hepatol. 2006 Jan;21(1 Pt 2):303-7
references.pmid: 16460491
references.citation: Intensive Care Med. 2011 Jan;37(1):86-96
references.pmid: 20924555
references.citation: World J Gastroenterol. 2011 Aug 14;17(30):3479-86
references.pmid: 21941414
references.citation: Cochrane Database Syst Rev. 2012;9:CD005162
references.pmid: 22972083
references.citation: Eur J Gastroenterol Hepatol. 1998 Jan;10(1):5-10
references.pmid: 9512946
references.citation: Hepatology. 2007 Jan;45(1):223-9
references.pmid: 17187409
references.citation: Am J Health Syst Pharm. 2003 Jul 1;60(13):1330-5
references.pmid: 12901034
references.citation: Hepatology. 2013 Apr;57(4):1651-3
references.pmid: 23463403
references.citation: Hepatology. 2009 May;49(5):1610-5
references.pmid: 19402063
references.citation: Hepatology. 1998 Sep;28(3):851-64
references.pmid: 9731583
references.citation: J Hepatol. 1992 Mar;14(2-3):310-6
references.pmid: 1380024
references.citation: Eur J Clin Pharmacol. 1997;52(6):465-70
references.pmid: 9342582
references.citation: N Engl J Med. 1999 Aug 5;341(6):403-9
references.pmid: 10432325
references.citation: J Hepatol. 2000 Jan;32(1):142-53
references.pmid: 10673079
references.citation: Pharm World Sci. 1999 Feb;21(1):11-6
references.pmid: 10214662
references.citation: Metab Brain Dis. 2016 Dec;31(6):1275-1281
references.pmid: 26290375
references.citation: J Hepatol. 2012 Oct;57(4):759-65
references.pmid: 22732511
references.citation: Liver Int. 2008 Aug;28(7):1019-25
references.pmid: 18410283
references.citation: Gastroenterology. 2008 May;134(5):1360-8
references.pmid: 18471513
references.citation: Hepatology. 2014 Aug;60(2):715-35
references.pmid: 25042402
references.citation: J Intern Med. 2006 Jul;260(1):62-8
references.pmid: 16789980
references.citation: Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9
references.pmid: 23474284
references.citation: J Gastroenterol Hepatol. 2003 Feb;18(2):152-6
references.pmid: 12542598
references.citation: Dig Dis Sci. 2008 Mar;53(3):830-5
references.pmid: 17939047
references.citation: Blood Transfus. 2013 Sep;11 Suppl 4:s26-32
references.pmid: 24333310
references.citation: Hepatology. 2006 Mar;43(3):385-94
references.pmid: 16496352
references.citation: Gastroenterology. 1990 Dec;99(6):1736-44
references.pmid: 1699835
references.citation: Liver Int. 2006 Feb;26(1):46-54
references.pmid: 16420509
references.citation: N Engl J Med. 2008 Jan 10;358(2):125-39
references.pmid: 18184958
references.citation: Hepatology. 2003 Jul;38(1):258-66
references.pmid: 12830009
references.citation: Hepatology. 2014 Dec;60(6):1851-60
references.pmid: 25048618
references.citation: Gastroenterology. 2008 May;134(5):1352-9
references.pmid: 18471512
references.citation: N Engl J Med. 2009 Sep 24;361(13):1279-90
references.pmid: 19776409
references.citation: Clin Gastroenterol Hepatol. 2012 Mar;10(3):309-15
references.pmid: 22094025
references.citation: J Hepatol. 2015 Nov;63(5):1272-84
references.pmid: 26192220
references.citation: N Engl J Med. 2008 Sep 4;359(10):1018-26
references.pmid: 18768945
references.citation: Hepatology. 2006 Dec;44(6):1535-42
references.pmid: 17133458
references.citation: J Hepatol. 2014 May;60(5):955-61
references.pmid: 24447876
references.citation: Dig Liver Dis. 2011 Nov;43(11):881-6
references.pmid: 21741331
references.citation: Ann Hepatol. 2002 Jan-Mar;1(1):29-35
references.pmid: 15114293
references.citation: Hepatology. 2003 Nov;38(5):1210-8
references.pmid: 14578859
references.citation: Hepatology. 2005 Sep;42(3):627-34
references.pmid: 16108036
references.citation: Am J Gastroenterol. 2008 Jun;103(6):1399-405
references.pmid: 18547224
references.citation: Hepatology. 2015 Aug;62(2):567-74
references.pmid: 25644760
references.citation: J Hepatol. 2012 Jun;56(6):1293-8
references.pmid: 22322237
references.citation: Hepatology. 1991 Apr;13(4):707-13
references.pmid: 1826281
references.citation: N Engl J Med. 2004 Apr 15;350(16):1646-54
references.pmid: 15084697
references.citation: Hepatology. 2002 Oct;36(4 Pt 1):941-8
references.pmid: 12297842
references.citation: Ann Emerg Med. 2014 Jan;63(1):35-47
references.pmid: 24067755
references.citation: Gut. 2007 Apr;56(4):597-9
references.pmid: 17369392
references.citation: Hepatology. 2003 May;37(5):1147-53
references.pmid: 12717396
references.citation: J Hepatol. 2007 Oct;47(4):499-505
references.pmid: 17560680
references.citation: Gastroenterology. 1996 Oct;111(4):1002-10
references.pmid: 8831595
references.citation: Blood Transfus. 2013 Sep;11 Suppl 4:s13-7
references.pmid: 24333305
references.citation: Gastroenterology. 1994 Mar;106(3):709-19
references.pmid: 8119542
references.citation: J Hepatol. 2014 Aug;61(2):396-407
references.pmid: 24751830
references.citation: Clin Gastroenterol Hepatol. 2013 Feb;11(2):123-30.e1
references.pmid: 23178229
references.citation: J Hepatol. 2011 Dec;55(6):1241-8
references.pmid: 21703199
references.citation: Hepatology. 1996 Jan;23(1):164-76
references.pmid: 8550036
references.citation: Gut. 2002 Jan;50(1):90-4
references.pmid: 11772973
references.citation: Liver Int. 2010 Sep;30(8):1137-42
references.pmid: 20602681
references.citation: Gut. 2007 Sep;56(9):1310-8
references.pmid: 17389705
references.citation: Gastroenterology. 1997 Aug;113(2):579-86
references.pmid: 9247479
references.citation: N Engl J Med. 2014 Apr 10;370(15):1412-21
references.pmid: 24635772
references.citation: Eur J Gastroenterol Hepatol. 2002 Dec;14(12):1363-8
references.pmid: 12468959
references.citation: Hepatology. 1994 Dec;20(6):1495-501
references.pmid: 7982650
references.citation: Eur J Intern Med. 2014 Mar;25(3):e31-2
references.pmid: 24125723
references.citation: Crit Care Med. 2011 Feb;39(2):386-91
references.pmid: 21248514
references.citation: Mol Aspects Med. 2012 Jun;33(3):209-90
references.pmid: 22230555
references.citation: Gastroenterology. 1988 Jun;94(6):1493-502
references.pmid: 3360270
references.citation: Liver Int. 2013 Sep;33(8):1187-93
references.pmid: 23601499
references.citation: World J Gastroenterol. 2006 Mar 7;12(9):1403-7
references.pmid: 16552809
references.citation: Hepatology. 1990 Apr;11(4):662-7
references.pmid: 2139430
references.citation: Ann Pharmacother. 2000 Oct;34(10):1198-205
references.pmid: 11054991
references.citation: Hepatology. 2013 Jan;57(1):266-76
references.pmid: 22911662
references.citation: Gastroenterology. 2005 Dec;129(6):1944-53
references.pmid: 16344063
references.citation: Clin Gastroenterol Hepatol. 2011 Mar;9(3):260-5
references.pmid: 21145427
references.citation: J Hepatol. 2015 Apr;62(4):822-30
references.pmid: 25463545
references.citation: Hepatology. 2013 Nov;58(5):1836-46
references.pmid: 23423799
references.citation: J Hepatol. 2001 Dec;35(6):726-32
references.pmid: 11738099
references.citation: J Hepatol. 1999 Apr;30(4):639-45
references.pmid: 10207805