Human albumin in the management of complications of liver cirrhosis.

Th e use of human albumin in the setting of liver cirrhosis is supported by evidence arising from prospective randomized trials and meta-analyses. Albumin administration is, therefore widely accepted and recommended by current international guidelines for the prevention of PPCD and acute renal failure in patients with SBP, and the treatment of HRS as an adjunct to vasoconstrictors. All these complications share the common patho physiological background of reduced eff ective volemia, mainly because of peripheral arterial vasodilation, and the rationale underlying the use of albumin is related to its activity as a plasma expander. However, it is likely that the benefi cial eff ects of albumin are also linked to its non-oncotic properties, including binding capacity, antioxidant activity, and eff ects on capillary integrity. Th ese eff ects represent the main fi elds of current and future research, from which will likely arise further and more appropriate indications for albumin administration in patients with liver disease.