Alternatives to albumin administration in hepatocellular carcinoma patients undergoing hepatectomy: An open, randomized clinical trial of efficacy and safety

Division of Liver Transplantation, West China Hospital, West China Medical School of Sichuan University, Chengdu, Sichuan 610041, China.
Chinese medical journal (Impact Factor: 1.05). 05/2011; 124(10):1458-64. DOI: 10.3760/cma.j.issn.0366-6999.2011.10.004
Source: PubMed


The value of artificial colloids in treating patients with liver disease is controversial. The effects of intravascular volume replacement regimens on liver function secondary to alteration of the postoperative inflammatory response are not known. In this study, we evaluated the effects of different volume replacement regimens in hepatocellular carcinoma patients undergoing hepatectomy to clarify whether albumin administration can be replaced by other volume replacement products.
Ninety consecutive hepatocellular carcinoma patients scheduled for hepatectomy were prospectively randomized to receive 20% human albumin (HA), 6% hydroxyethyl starch (HES) or lactated Ringer's solution (LR) for postoperative volume replacement. Hemodynamic, liver function and inflammatory response parameters were recorded on postoperative days one, three, and five throughout the investigation period.
Significantly less volume was required in the HA and the HES groups. Although patients in all groups had similar baseline values, the plasma osmolality was significantly higher in the HA and HES groups. Total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) increased from baseline in all groups, and did not differ significantly between groups. C-reactive protein (CRP) was significantly lower in the HES group compared with the other groups.
In hepatocellular carcinoma patients undergoing hepatectomy, HA can be replaced by HES or LR in well selected patients. Hemodynamic stability, liver function, and postoperative clinical outcomes could be equivalently achieved in the HES group; also, HES may exert more favorable effects on the acute phase response.

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    • "0% , p = 0 . 705 ) James 2011 Gondos 2010 Kasper 2003 Ooi 2009 Langeron 2001 Lu 2012 Inal 2010 Mahmood 2007 Dubin 2010 Siegemund 2012 Boldt 2000 Yang 2011 Sander 2003 Subtotal ( I - squared = 0 . 0% , p = 0 . "
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