ALBI grade
The albumin-bilirubin (ALBI) score grades liver function from two laboratory values alone, without ascites or encephalopathy. It was developed in hepatocellular carcinoma as an objective alternative to the Child-Pugh score.
ALBI score: enter bilirubin and albumin
How it is worked out
ALBI score = (log₁₀ bilirubin × 0.66) + (albumin × −0.0852)
Bilirubin in µmol/L and albumin in g/L. A lower (more negative) score means better liver function.
| ALBI score | Grade |
|---|---|
| −2.60 or less | Grade 1 |
| Above −2.60 up to −1.39 | Grade 2 |
| Above −1.39 | Grade 3 |
Notes
- Grade 1 indicates the best liver function and grade 3 the worst. Survival in hepatocellular carcinoma falls with each grade.
- The score was derived and validated in hepatocellular carcinoma cohorts. It does not replace the Child-Pugh score or MELD for other purposes, such as transplant assessment.
- Albumin measured by different laboratory methods is not interchangeable, which shifts the score slightly.
Reference
Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach — the ALBI grade. J Clin Oncol. 2015;33(6):550-558.Formula and grades