Increased survival in advanced primary biliary cirrhosis patients with regular albumin infusions?

Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease. Frequently, it can slowly progress to cirrhosis and, finally, death. Liver transplantation is the only way to avoid this endpoint. For patients not accepted for liver transplantation, only symptomatic treatment remains. In advanced PBC, one of the main concerns is a decreasing albumin level. As albumin is an important protein in the human body, we wondered whether regular albumin infusions may result in a higher quality of life and prolong survival. In this case report we describe three patients who survived for a remarkably long time on this treatment regimen before finally succumbing to the sequela of advanced liver disease. Some features of albumin are mentioned which may help explain this phenomenon. We conclude that regular albumin infusions may be a means of decreasing morbidity and prolonging survival in a subgroup of patients with advanced PBC. However, prospective evaluation of regular albumin infusions in a group of PBC patients (e.g. those rejected for liver transplantation) seems mandatory.