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Ramadori. Hepatoma Res 2020;6:28 I http://dx.doi.org/10.20517/2394-5079.2020.43 Page 3 of 10

Figure 1. Panel A shows the results of in-situ-hybridisation analysis performed in slices of embrional liver at different stages of
developement in NB and Ad rats. The intensity of the reaction demonstrates an abundance of albumin-specific mRNA. NB: newborn; Ad:
adult. Histochem Cell Biol 2007;128:431-43. (reprinted with permission) [37]

The prognostic importance of serum albumin levels in patients with liver disease is demonstrated by the
inclusion of this parameter in the Child-Turcotte-Pugh score, used to assess the prognosis of chronic liver
[32]
disease, mainly cirrhosis. This score was introduced by surgeons in 1963 .
In addition, serum albumin level is a key nutritional parameter used to estimate the grade of malnutrition, and
to predict survival in patients with liver cirrhosis. Malnutrition is an independent risk factor for transplantation,
[33]
and improves the prognostic value of the Child-Turcotte-Pugh score, reported by Alberino et al. .
While administration of albumin in patients with advanced liver disease and hypoalbuminemia is now a
standard therapy, albumin administration in critically ill patients with or without liver disease in the ICU is
controversial [34-36] .