Analysis of morbidity in liver transplant recipients following human albumin supplementation: a retrospective pilot study

OBJECTIVES: To assess incidence of morbidity (i.e., documented infection, acute renal failure, acute graft rejection, acute cardiovascular events, and hospital readmission rates) 6 months following liver transplantation using linear regression as a function of cumulative albumin dose. DESIGN: Retrospective chart review. SETTING: A 473-bed tertiary care teaching facility with a solid-organ transplantation center. PATIENTS: Forty liver transplant recipients examined from January 1 to December 31, 2003. MEASUREMENTS AND RESULTS: Data from 40 liver transplant recipients were collected. Mean albumin dose administered was 190.9 +/- 162.3 g. No statistical differences were identified in patients receiving less than 140 g (n=20) or more than 140 g (n=20) with respect to demographic data other than gender and ethnicity. The mean APACHE III (Acute Physiology and Chronic Health) score was 69.7 +/- 24.3. Approximately 70 episodes of morbidity and 23 readmissions were observed. Regardless of the APACHE III score, albumin was associated with increased overall morbidity and cardiovascular complications. Liver transplant recipients receiving more than 140 g had a longer hospital stay (14 vs. 8 days, P = .025) and intensive care unit stay (6 vs. 3 days, P = .051) than patients receiving 140 g or less. No correlation with risk of acute rejection was seen with albumin or tacrolimus. Conclusion-Albumin supplementation among liver transplant recipients was associated with a significant risk for cardiovascular complications and overall number of complications regardless of APACHE III score. Future prospective studies are needed to further define the potential risk for complications in this patient population.