Human Albumin Infusion for the Management of Liver Cirrhosis and Its Complications: An Overview of Major Findings from Meta-analyses

被引：7

作者：

Zheng, Xiaojie ^{[1
,2
]}

Bai, Zhaohui ^{[1
,3
]}

Wang, Ting ^{[1
,3
]}

Romeiro, Fernando G. ^{[4
]}

Mancuso, Andrea ^{[5
]}

Philips, Cyriac A. ^{[6
]}

Wong, Yu J. ^{[7
,8
]}

Nery, Filipe G. ^{[9
]}

Qi, Xingshun ^{[1
,2
,3
]}

机构：

[1] Gen Hosp Northern Theater Command, Dept Gastroenterol, 83 Wenhua Rd, Shenyang 110840, Liaoning, Peoples R China

[2] China Med Univ, Postgrad Coll, Shenyang, Peoples R China

[3] Shenyang Pharmaceut Univ, Dept Life Sci & Biopharmaceut, Shenyang, Peoples R China

[4] Botucatu Med Sch, Internal Med Dept, Sao Paulo, Brazil

[5] Azienda Rilievo Nazl Alta Specializzaz Civ Dr Cri, Med Interna 1, Palermo, Italy

[6] Rajagiri Hosp, Liver Inst, Ctr Excellence GI Sci, Clin & Translat Hepatol, Aluva, India

[7] Changi Gen Hosp, Dept Gastroenterol & Hepatol, Singapore, Singapore

[8] SingHlth, Duke NUS Med Sch, Singapore, Singapore

[9] Ctr Hosp Univ Porto, Unidade Cuidados Intermedios Med Cirurg, Serv Cuidados Intens, Porto, Portugal

来源：

ADVANCES IN THERAPY | 2023年 / 40卷 / 04期

关键词：

Albumin; Cirrhosis; Guideline; Overview; Meta-analysis; Systematic review; SPONTANEOUS BACTERIAL PERITONITIS; SIMTI POSITION PAPER; CIRCULATORY DYSFUNCTION; APPROPRIATE USE; ADULT PATIENTS; ASCITES; INFLAMMATION; EFFICACY; SAFETY; PARACENTESIS;

D O I：

10.1007/s12325-023-02430-3

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Introduction: The role of human albumin (HA) infusion in cirrhotic patients has been increasingly recognized. This paper aims to summarize the evidence from meta-analyses regarding HA infusion for the management of cirrhosis and its complications. Methods: A systematic search in the PubMed, EMBASE, and Cochrane library databases, and in reference lists was conducted. All relevant meta-analyses were identified and their findings were reviewed. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist was used to evaluate the methodological quality and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system to assess the quality of evidence for significant outcomes. Results: Among 300 papers initially identified, 18 meta-analyses have been included. Short- and long-term HA infusion at high doses decreased the mortality of patients with decompensated cirrhosis. In cirrhotic patients with ascites, long-term HA infusion reduced the recurrence of ascites, but not mortality. In cirrhotic patients undergoing large-volume paracentesis (LVP), HA infusion reduced the incidence of post-paracentesis circulatory dysfunction and hyponatremia, but not mortality or renal impairment. In cirrhotic patients with overt hepatic encephalopathy (HE), HA infusion improved the severity of overt HE, but not overall mortality. In cirrhotic patients with spontaneous bacterial peritonitis (SBP), but not those with non-SBP infections, HA infusion reduced the mortality and renal impairment. In cirrhotic patients with type-1 hepatorenal syndrome (HRS), an increment of 100 g in cumulative HA dose increased 1.15-fold survival, but not HRS reversal. In these meta-analyses, the quality of methodology was low or critically low, and that of the evidence was from very low to moderate. Conclusions: Based on the limited evidence from these meta-analyses, HA infusion appears to be beneficial in cirrhotic patients with ascites, overt HE, and SBP and in those undergoing LVP, but not in those with non-SBP infections.

引用

页码：1494 / 1529

页数：36