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Major Trials

Liver

Albumin

Cirrhosis
Spontaneous Bacterial Peritonitis
Infections

Fluids

Albumin

Cirrhosis

China. A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis. N Engl J Med 2021;384:808-817
Caraceni. Long‑term albumin administration in decompensated cirrhosis (ANSWER): an open‑label randomised trial. Lancet 2018;391(10138):2417‑2429

Spontaneous Bacterial Peritonitis

Sort. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999;341:403–409

Infections

Guevara. Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study. J Hepatol 2012;57:759–765

Hepatorenal Syndrome

Albumin

Upper GI Bleeding

TIPS

García‑Pagán. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med 2010;362(25):2370‑2379

Red Cell Transfusion

Villanueva. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11‑21

Extracorporeal Support

Prometheus

Kribben. Effects of Fractionated Plasma Separation and Adsorption on Survival in Patients With Acute-on-Chronic Liver Failure (HELIOS study). Gastroenterology 2012;142(4)782-789

MARS

Bañares. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute‑on‑chronic liver failure: the RELIEF trial. Hepatology 2013;57(3):1153‑1162

N-Acetylcysteine

Paracetamol Liver Injury

Keays. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial. BMJ 1991;303:1026-1029

Non-Paracetamol Liver Injury

Hypothermia

Acute Liver Failure

Bernal. A multicentre randomized controlled trial of moderate hypothermia to prevent intracranial hypertension in acute liver failure. J Hepatol 2016;65:273-279

Alcoholic Hepatitis

Antibiotics

Louvet. Effect of Prophylactic Antibiotics on Mortality in Severe Alcohol-Related Hepatitis. A Randomized Clinical Trial. JAMA 2023;329(18):1558-1566

Steroids

Thursz. Prednisolone or pentoxifylline for alcoholic hepatitis. N Engl J Med 2015;372(17):1619‑1628

Antifungal Therapy

Verma. Empirical Antifungal Therapy Improves Survival in patients with Acute-on-Chronic Liver Failure with Suspected Invasive Fungal Infections: A Pragmatic Randomised Trial. Am J Gastroenterol 2025;epublished November 21st

Last updated December 27th, 2025