Marek Rác, Tomáš Koller, Ľubomír Skladaný, Martin Janíčko, Peter Jarčuška
Human serum albumin (HSA) is the most abundant circulating plasma protein, accounts for about 80 % of the plasma
colloid osmotic pressure. Beside of plasma expanding function, albumin is provided of many other physiological properties.
Albumin is more than simple volume expander. HSA has many other physiological functions, unrelated to oncotic
properties. This functions are binding and transport of many endogenous and exogenous substances, antioxidant
function, scavenger function, immunomodulation, antiinflamatory activity and endothelium stabilisation. Some
of his properties are potential for future indications. In the cirrhosis is hypoalbuminaemia caused by lower synthesis,
dilution and extravasation. Liver cirrhosis is associated with significant structural and functional modification of
the molecule of the albumin. This abnormality markedly affect its biological activity. Alteration in the functional capacity
of albumin in patients with liver dysfunction in cirrhosis is associated with increased mortality. Treatment of hepatorenal
syndrome or prevention of renal failure in spontaneous bacterial peritonitis and post paracentesis circulatory
dysfunction after large volume paracentesis represents the major evidence-based clincal indications for albumin administration
in hepatology. New research in the field of albumin biology in the liver failure has opened new potential
indications for albumin use. The ultimate goal of albumin administration is not a target albumin concentration but effective
albumin concentration.