Human albumin: old, new, and emerging applications

Area of Science:

• Biochemistry and Physiology
• Clinical Medicine
• Pharmacology

Background:

• Human serum albumin (HSA) has been a cornerstone in clinical settings for decades.
• Its use extends beyond oncotic function, encompassing crucial physiological roles.
• Increased understanding of HSA's physiology has led to broader medical applications.

Purpose of the Study:

• To review current knowledge on HSA chemistry, physiology, and medical applications.
• To analyze the relevance of HSA therapy in various clinical scenarios.
• To address the implications of HSA shortages and rising costs on its utilization.

Main Methods:

• Comprehensive analysis of major publications on HSA.
• Inclusion of guidelines from professional and governmental organizations.
• Review of studies on HSA chemistry, physiology, and therapeutic uses.

Main Results:

• HSA therapy is recommended for spontaneous bacterial peritonitis, refractory ascites, and hepatorenal syndrome.
• Emerging indications leverage HSA's antioxidant and capillary-stabilizing properties.
• Novel therapies like hemofiltration and albumin exchange show promise for liver failure and toxic syndromes.

Conclusions:

• Current HSA usage criteria and guidelines require re-evaluation due to shortages and cost.
• New protocols are needed for appropriate utilization of HSA in clinical practice.
• Further research into HSA's multifaceted roles may uncover new therapeutic avenues.