Reduction in albumin binding function following liver resection in patients with and without cirrhosis

Assessing liver function in patients undergoing liver resection is crucial. As albumin concentration is regarded as an important marker of liver function (1,2), serum albumin concentration rather than its binding function is usually determined. Albumin concentration, however, is not an accurate determinant of albumin binding activity, as circulating albumin may have lost its binding function. The three-dimensional structure of albumin is altered when liver function is impaired, reducing the ability of albumin to bind to its ligands. This may result in the failure to remove metabolic products, including bilirubin, and drugs from the body (3,4). Measuring both albumin concentration and binding function can better indicate actual liver function, thus guiding clinical practice