🫀 ALBI Grade (Albumin-Bilirubin)
The ALBI (albumin-bilirubin) grade objectively measures hepatic functional reserve using only two laboratory values.
ALBI Grade (Albumin-Bilirubin)
Total bilirubin (μmol/L)
Albumin (g/L)
When to use
Enter total bilirubin and albumin; the tool computes the ALBI score and assigns grade 1, 2, or 3.
How it works
ALBI score = 0.66 × log₁₀(bilirubin in μmol/L) − 0.085 × (albumin in g/L). Grade 1 ≤ −2.60, Grade 2 −2.60 to −1.39, Grade 3 > −1.39.
Key points
- ALBI avoids the subjective ascites and encephalopathy components of Child-Pugh, making it more reproducible for HCC stratification (original synthesis · not guideline verbatim).
- Grade is widely used to gauge tolerance of liver resection and transarterial chemoembolization.
- An ALBI-based modification of Child-Pugh (the ALBI grade within stage A) further separates prognosis in compensated cirrhosis.
References
- Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: the ALBI grade. J Clin Oncol. 2015.
- Hiraoka A, et al. Validation and potential of ALBI grade for HCC. Liver Cancer. 2017.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.