Hyperoncotic 25% albumin is indicated for patients with cirrhosis and transudative ascites undergoing large volume paracentesis (>5L) to reduce the risk of paracentesis-induced circulatory dysfunction. Guidelines for malignant ascites do not recommend albumin administration, as malignant ascites is an exudative process rather than the transudative ascites in patients with cirrhosis, therefore, albumin is not recommended in this setting.
Sources:
Callum J, et al. Use of intravenous albumin: a guideline from the International Collaboration for Transfusion Medicine Guidelines. Chest. 2024 Aug;166(2):321-338. Epub 2024 Mar 4. PMID: 38447639.
Matsusaki K, et al. Clinical practice guideline for the treatment of malignant ascites: section summary in Clinical Practice Guideline for peritoneal dissemination. Int J Clin Oncol. 2022 Jan;27(1):1-6. Epub 2021 Nov 20. PMID: 34800177.
Simonetti RG, et al. Plasma expanders for people with cirrhosis and large ascites treated with abdominal paracentesis. Cochrane Database Syst Rev. 2019;6(6):CD004039. PMID: 31251387.