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Albumin To prevent Infection in chronic liver failure

ATTIRE is a randomised controlled trial to investigate the use of albumin in patients with advanced liver cirrhosis. ATTIRE is funded by the Department of Health and Wellcome Trust.

Liver cirrhosis results in liver tissue becoming scarred and developing lumps. These changes can prevent the liver from functioning properly. There are about 60,000 patient admissions each year due to complications of liver cirrhosis. These patients are at a higher risk of developing an infection during their hospital stay due to a weakened immune system.

One function of the liver is to produce albumin. Patients with liver cirrhosis may have albumin levels in the blood much lower than normal. This trial is investigating whether boosting albumin levels through targeted infusions of 20% Human Albumin Solution will reverse immune suppression and prevent infection.

The primary outcome for ATTIRE is the incidence of infection during the hospital admission.

Publications

• Louise China, Ph.D., Nick Freemantle, Ph.D., Ewan Forrest, M.D., Yiannis Kallis, Ph.D., Stephen D. Ryder, D.M., Gavin Wright, Ph.D., Andrew J. Portal, M.D., Natalia Becares Salles, Ph.D., Derek W. Gilroy, Ph.D., and Alastair O’Brien, Ph.D. for the ATTIRE Trial Investigators |  | DOI: 10.1056/NEJMoa2022166
• China L, Skene SS, Shabir Z, Maini AA, Sylvestre Y, Bennett K, Bevan S, O'Beirne J, Forrest E, Portal J, Ryder S, Wright G, Gilroy DW, O'Brien A. . Clinical Gastroenterology and Hepatology, Article in press; Published online: 11 Sep 2017
• China L, Maini AA, Skene SS, Shabir Z, Sylvestre Y, Colas RA, Ly L, Salles NB, Belloti V, Dalli J, Gilroy DW, O'Brien A.  Clinical Gastroenterology and Hepatology, 2017 Aug 28; Article in press; Published online: 30 Aug 2017
• China L, Muirhead N, Skene SS, Shabir Z, De Maeyer RPH, Maini AAN, Gilroy DW, O'Brien AJ. ATTIRE: Albumin To prevenT Infection in chronic liveR failurE: study protocol for a single-arm feasibility trial.  BMJ Open 2016; 6: e010132

ISRCTN14174793