Efficacy of albumin infusion for hypoalbuminemia in post operative period in living donor liver transplantation – An open label randomised controlled trial

Albumin’s role post-liver transplant is debated, with its use aimed at volume replacement and hemodynamic stability. Post-transplant hypoalbuminemia results from multiple factors like capillary leakage due to surgery-induced inflammation. Studies indicate increased albumin synthesis but decreased plasma levels, suggesting redistribution or altered degradation in the post-transplant period. Albumin infusion risks overhydration and volume overload. Previous studies have concluded that critically ill post-transplant patients gain no hemodynamic benefit from albumin over other fluids. Clinically, in our experience (high volume living donor liver transplant center) albumin hasn’t improved fluid management or inotropic support, leading instead to fluid overload, increased drain output, potential tacrolimus toxicity, and higher treatment costs. We planned this trial to assess the efficacy of albumin and rationalize the use of albumin therapy in the postoperative period of liver transplantation.