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Analysis of Morbidity in Liver Transplant Recipients following Human Albumin Supplementation: A Retrospective Pilot Study

regarding the best method of fluid resuscitation in critically ill patients. Much of this debate is rooted in concerns for efficacy and safety and healthcare costs between crystalloid and colloid solutions. In 1975, members of the Division of Blood Diseases and Resources; the Division of Blood and Blood Products, Bureau of Biologics; and National Heart and Lung Institute conducted a workshop to establish guidelines for the appropriate use of albumin as an option for fluid resuscitation. The group recommended a number of clinical indications for the therapeutic use of albumin still recognized today, including hemodynamic instability or shock, ascites, acute liver failure, acute respiratory distress syndrome, and preoperative and postoperative hypoproteinemia. Through this process, members also assessed safety reports and other analyses and attributed many of the concerns with albumin solution to an incompatibility syndrome in which patients experience nausea, chills, fever, headache, hypotension, and urticaria. Concerns for safety in the midst of efficacy debates sparked a number of meta-analyses in the late 1990s evaluating the mortality of patients receiving albumin supplementation. In 1998, the Cochrane Injuries Group Albumin Reviewers examined 30 randomized trials with 1419 trauma and general surgery, burn, and hypoalbuminemic patients and found an increased risk of death when compared to colloid solutions (RR 1.68; 95% CI, 1.26-2.23). Some clinicians have identified limitations Analysis of morbidity in liver transplant recipients following human albumin supplementation: a retrospective pilot study