#115 - Effectiveness of Long-Term Albumin Administration in Patients With Decompensated Cirrhosis: Real-World Experience From Brazil

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Introduction and Objectives Longterm albumin (LTA) administration has emerged as a diseasemodifying strategy for patients with decompensated cirrhosis and ascites, with evidence of reduced complications and mortality. However, real-world data from Latin America remain limited. The study describes clinical characteristics and liver-related complications in patients with decompensated cirrhosis receiving LTA in Brazilian clinical practice. Patients and Methods This retrospective study included patients with liver disease and refractory ascites-diuretic intolerance (as defined in 2021 AASLD guidelines) who initiated LTA during hospitalization for acute decompensation between 2019 and 2024 at four private centers in São Paulo, Brazil. Albumin was administered at 40g/week for at least 12 weeks, targeting serum albumin levels of 4g/dL. Clinical, biochemical, and prognostic parameters were evaluated at baseline, 4, 12, and 24 weeks after LTA initiation. Results Among the 22 patients included (mean age 66.7 years; 54.5% male), cirrhosis etiology was heterogenous, reflecting a diverse cohort. Baseline disease severity was advanced, with mean MELD score of 20.8, 59.1% classified as Child-Pugh C and all patients presenting grade 2 or 3 ascites. Median LTA duration was 18.1 weeks, with good adherence. By week 12, 77.3% achieved serum albumin levels of 4g/dL. Improvements were observed with reductions in creatinine, bilirubin, INR, MELD, and Child–Pugh scores. Ascites severity, diuretic requirements, and the need for paracentesis decreased, and liverrelated complications were infrequent during followup. Conclusions This realworld Brazilian cohort supports the clinical value of LTA, evidenced by improved ascites management, reduced diuretic use, favorable prognostic scores changes, and fewer liver-related complications.