Sponsored: Human albumin: Liver Disease SE Asia - Page 24

FIGURE 1
Treatment options depending on BCLC stage of early / intermediate HCC 11
BCLC O-A BCLC B
Resection Liver transplant
Ablation TACE
Liver transplant Resection
TACE
Stereotactic body radiotherapy Brachytherapy Selective internal radiotherapy ( SIRT )
TACE failure / refractoriness
Systemic therapy SIRT
incidence of postoperative IAI was significantly higher in those with preoperative serum albumin < 35g / l than those with serum levels ≥35g / l . 23 A low serum albumin level after hepatectomy is also an important predictive factor . For liver transplantation donors with normal liver function , the risk of postoperative pleural effusion increased by 69 % in those with the minimum serum albumin of ≤3.0g / dl on day 2 after hepatectomy compared with those whose levels were > 3.0 g / dl . 24 Finally , in another retrospective analysis of 998 patients who underwent living donor liver transplantation , the mortality rate was significantly higher and the length of stay in the ICU was longer , in those having postoperative serum albumin of < 3.0g / dl than for those having levels ≥3.0g / dl . 25
Taken together , these data highlight the clinical benefit associated with perioperative human albumin infusion in hepatectomy and liver transplantation .
Conclusion HCC is a major cause of global cancer-related mortality , especially in Asian and African countries . Surveillance programmes allow for the premature detection of the cancer and early-stage HCC is amenable to potentially curative treatment with several modalities including surgical resection , localised ablative therapies and liver transplantation . Future guidelines should emphasise the importance of perioperative albumin as a prognostic factor in liver transplantation .
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