Influence of long-term administration of serum albumin on the prognosis of liver cirrhosis in man.

To investigate the efficacy of long term administration of salt-poor albumin in the prognosis of cirrhotic patients with ascites, we administered albumin for more than six months at regular intervals to nine cirrhotic patients who had been confirmed to have ascites for the first time, and maintained their serum albumin levels above 3.0 g/dl. The other 11 cirrhotic patients who had also developed ascites for the first time were treated with diuretics only, as a control group. In the albumin treated group, one patient developed a hepatoma, and another had acute viral hepatitis after transfusion during splenectomy, and they were excluded. In the control group, one developed chronic liver failure after an operation for choledocholithiasis, and she was excluded from the study. All seven patients who had been administered albumin survived for more than two years, whereas three out of 10 in the control group died of chronic liver failure within two years. In the patients who showed a B.S.P. retention rate of more than 35% at the beginning of the study, all five treated with albumin survived for more than two years, whereas three out of four in the control group died within two years (P less than 0.025). In the albumin treated patients, the increase in serum albumin level was generally accompanied by an increase in the choline-esterase level. Long term administration of serum albumin to cirrhotic patients with ascites appears to lead to a better prognosis.