{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:13:49Z","timestamp":1783430029185,"version":"3.54.6"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cirrhosis is a global health concern, with ascites being the most prevalent decompensating event. Intravenous (IV) human albumin (HA) is administered during large\u2010volume paracentesis (LVP) to prevent complications. The standard (6\u20138\u2009g HA\/L ascites) is empirically chosen, potentially leading to overtreatment and added costs. We reviewed evidence comparing the efficacy and safety of reduced versus standard\u2010care HA dosing during LVP. We searched PubMed, EMBASE, Cochrane Library, CINAHL, and Scopus (up to January 31, 2025). We included RCTs and cohort studies in adults with cirrhosis undergoing LVP, comparing low\u2010dose (\u2264\u20096\u2009g\/L or \u2264\u200920\u2009g total) to standard\u2010dose (&gt;\u20096\u2009g\/L or &gt;\u200920\u2009g total) HA. Outcomes included paracentesis\u2010induced circulatory dysfunction (PICD), renal impairment, hyponatremia, other decompensating events, and survival. Quality assessment used Cochrane risk\u2010of\u2010bias tools and Newcastle\u2013Ottawa Scale. Five studies (three full\u2010text, two abstracts) met inclusion criteria. Low\u2010dose regimens (2\u20136.5\u2009g\/L) showed no significant difference compared to standard care (6\u20138.3\u2009g\/L) in PICD (reported in two studies) and renal dysfunction (reported in five studies). Other secondary outcomes, including hyponatremia, GI bleeding, HE, infections, and reaccumulating ascites, also showed no statistical differences. While these findings indicate potential for dose reduction, definitive confirmation via meta\u2010analysis was not feasible due to methodological heterogeneity. Available evidence suggests that reduced\u2010dose IV HA (\u2264\u20096\u2009g\/L) is as effective and safe as standard\u2010dose HA (6\u20138\u2009g\/L) during LVP. However, the quality of the current evidence is limited by small sample sizes and suboptimal study designs, and well\u2010designed, adequately powered future studies are required to confirm these findings.<\/jats:p>","DOI":"10.1111\/liv.70621","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:15:58Z","timestamp":1774592158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low\u2010Dose vs. Standard Care Iv Human Albumin During Large\u2010Volume Paracentesis in Patients With Liver Cirrhosis: A Systematic Review"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5761-7058","authenticated-orcid":false,"given":"Kimberly K. I. M.","family":"Bot","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roebi","family":"Heus","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost P. H.","family":"Drenth","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam the Netherlands"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER)  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3137-901X","authenticated-orcid":false,"given":"Marten A.","family":"Lantinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism  Amsterdam the Netherlands"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER)  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2328521"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01374-X"},{"issue":"4","key":"e_1_2_13_4_1","first-page":"265","article-title":"Preventing the Progression of Cirrhosis to Decompensation and Death","volume":"22","author":"Villanueva C.","year":"2025","journal-title":"Nature Reviews. 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