From the FDA Drug Label
CONTRAINDICATIONS Certain patients, e.g., those with a history of congestive cardiac failure, renal insufficiency or stabilized chronic anemia, are at special risk of developing circulatory overload. A history of an allergic reaction to albumin is a specific contraindication to usage. The contraindications of Albumin (Human Albumin) infusion are:
- A history of allergic reaction to albumin It is also important to exercise caution in patients with:
- Congestive cardiac failure
- Renal insufficiency
- Stabilized chronic anemia due to the risk of developing circulatory overload 1
From the Research
Albumin infusion is contraindicated in patients with hypersensitivity to albumin, severe anemia, heart failure in patients at risk for hypervolemia, and pulmonary edema. The use of albumin has been extensively studied, and its indications and contraindications have been well-established [ 2 ]. According to the most recent and highest quality study, albumin should not be used in hypoalbuminemia or for nutritional purposes [ 2 ]. The main evidence-based indications for albumin administration are liver disease, fluid replacement in plasmapheresis, and liver diseases, including hepatorenal syndrome, spontaneous bacterial peritonitis, and large-volume paracentesis [ 2 ].
Some of the key points to consider when administering albumin include:
- Hypersensitivity to albumin is a major contraindication [ 3 ]
- Severe anemia, heart failure in patients at risk for hypervolemia, and pulmonary edema are also contraindications [ 2 ]
- Albumin administration can cause allergic and transfusion reactions, volume overload, antibody formation, and coagulation derangements [ 3 ]
- The use of albumin should be rationalized in terms of dose, duration, and frequency in different liver diseases and stages of cirrhosis [ 3 ]
It is essential to note that the use of albumin should be guided by evidence-based recommendations, and its administration should be tailored to the individual patient's needs and medical condition [ 2 ]. The most recent study provides updated evidence-based instructions for the use of albumin in clinical practice, including appropriate dosing and duration [ 2 ].
In terms of specific conditions, albumin is most indicated in the management of cirrhosis complications, such as hepatorenal syndrome, spontaneous bacterial peritonitis, and large-volume paracentesis [ 2, 4 ]. Long-term albumin administration can also modify the course of decompensated cirrhosis patients by reducing the onset of new complications, improving the quality of life, and probably providing survival benefits [ 3, 5 ].
Overall, the use of albumin should be carefully considered, and its contraindications should be taken into account to ensure the best possible outcomes for patients [ 2 ].