Before Liver Surgery for Liver Cancer
Surgery for HCC should rest on a multi-part assessment. One part is a combined check of liver function using ALBI, Child-Pugh, or MELD. The goal is to keep the risk of serious problems after surgery low.
AI Summary The ALBI score turns two routine blood tests, albumin and bilirubin, into one number that describes liver function. Doctors use it mainly before liver cancer surgery and when choosing treatment, as one tool among Child-Pugh, MELD, imaging, and other factors. It does not diagnose disease, and one result is only a snapshot. Repeat tests show trends. Ask your care team which score they used, what it means for you, and report new symptoms such as jaundice or swelling.
Source: www.liverdirectory.com
ALBI Score
Medically Reviewed.
The ALBI score, short for albumin-bilirubin score, turns two blood test results into one number that describes liver function. Albumin is a protein your liver makes. Bilirubin is a yellow pigment that builds up when the liver is not clearing it well.
Doctors most often use it when they need to know how much liver function a person has in reserve, for example before liver surgery for liver cancer. It needs no scan or biopsy, and it never stands alone.
This page explains what goes into the score, when doctors use it, how it compares with other liver scores, and what to ask your care team.
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ALBUMIN-BILIRUBIN SCORE BASICS
What Is the ALBI Score?
The ALBI score (albumin-bilirubin score) is a way to describe liver function with just two blood tests. Doctors may also call the result an ALBI grade.
Albumin is the main protein your liver makes. It supports your immune system and carries hormones, drugs, and enzymes through the blood. Low albumin can be a sign of liver damage.
Bilirubin is a yellow substance made when old red blood cells break down. When the liver is damaged, bilirubin can leak into the blood and cause jaundice, a yellow tint to the skin and eyes.
Doctors can use ALBI, Child-Pugh, or MELD to assess liver function when they plan surgery for hepatocellular carcinoma (HCC), the most common type of primary liver cancer.
The ALBI score does not diagnose liver disease or cancer. It describes how well the liver is working at the time of the blood draw. This page does not list the formula or grade cutoffs. Your care team can tell you which results they used and how your number is grouped.
ALBI Score at a Glance
- ALBI stands for albumin-bilirubin. It uses two blood tests that are part of common liver panels.
- It needs no biopsy or scan. The result comes from blood work.
- ALBI, Child-Pugh, and MELD are options for assessing liver function before liver surgery for HCC.
- That assessment also looks at portal hypertension, how much liver will remain after surgery, performance status, and other health conditions. ALBI is one piece.
- Low albumin can point to liver damage. Raised bilirubin can cause jaundice.
- One result is a snapshot. Repeated tests show whether liver function is improving, stable, or declining.
- Only your care team can interpret your score in light of your full health picture.
WHEN DOCTORS USE ALBI
Why Your Doctor Might Use the ALBI Score
The ALBI score answers one question: how much working liver do you have? That answer helps shape treatment choices, especially in liver cancer.
When Choosing a Liver Cancer Treatment
The right liver cancer treatment depends on the stage of the cancer, liver function, and overall health. Some medicines are used only when liver function is adequate. A liver function score helps your team judge that.
To Follow Liver Function Over Time
Liver blood tests change gradually. Your doctor may repeat them to see whether your liver is improving, staying stable, or needing a closer look. A series of results tells more than a single one.
As One Tool Among Several
No single score decides your care. Your team also considers portal hypertension, imaging, the size and position of any tumor, how much liver would remain, your daily function, and other health conditions.
ALBUMIN AND BILIRUBIN LEVELS
The Blood Tests Behind the Score
The ALBI score uses these two blood tests. Typical ranges are shown below. Labs can differ slightly, so use the range printed on your own report.
Albumin
The main protein your liver makes. It supports immune function and carries hormones, drugs, and enzymes.
3.5–5.0 g/dL
May be linked to changes in liver function, malnutrition, chronic inflammation, or certain other medical conditions.
Expected range.
Often related to dehydration or fluid loss, such as from diarrhea.
Bilirubin
A yellow substance made when old red blood cells break down. It gives bile its color.
0.1–1.2 mg/dL
Usually not a concern.
Expected range.
May suggest liver or bile flow changes, increased red blood cell breakdown, or a harmless condition such as Gilbert's syndrome.
A Range Is Not Your ALBI Score
Your ALBI score is a calculated number, and these ranges are not its cutoffs. An abnormal albumin or bilirubin result is a reason to talk with your doctor, not a diagnosis.
ALBI VS CHILD-PUGH AND MELD
ALBI Compared With Other Liver Scores
ALBI and Child-Pugh
ALBI uses only two blood tests. The Child-Pugh score sorts people with cirrhosis into class A, B, or C and also takes in clotting and complications such as fluid in the abdomen. Both are used to assess liver function before HCC surgery.
ALBI and MELD
MELD uses bilirubin, creatinine, and INR, and sometimes sodium. It is mainly used to prioritize people for liver transplant and to estimate short-term risk in advanced liver disease. ALBI leaves out kidney and clotting results.
ALBI and ICU Scores
SOFA and CLIF-C ACLF are built for severe illness. Guidance on acute-on-chronic liver failure favors ACLF-specific scores over MELD-type scores. ALBI sits in this group on our site, but it is mainly discussed as a liver function measure before cancer surgery.
AFTER YOUR ALBI RESULT
What to Do After You Learn Your Score
Ask What the Number Means for You
Ask your doctor which score they used and why. A score is only useful when it is tied to a decision, such as whether surgery is safe or which treatment fits your liver.
Keep Up With Repeat Blood Tests
Albumin and bilirubin can shift with illness, nutrition, and medicines. Keep your lab appointments so your team can see the trend, not just one result.
Report New Symptoms
Call your care team promptly if you notice yellowing of the skin or eyes, new swelling in the belly or legs, or new confusion. These can signal that liver function has changed.
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Common Questions
Answers to Common ALBI Score Questions
What Is the ALBI Score?
The ALBI score is a calculated number that describes liver function using two blood tests, albumin and bilirubin. Albumin is a protein your liver makes, and low levels can be a sign of liver damage. Bilirubin is a yellow substance that can build up in the blood and cause jaundice when the liver is damaged. Doctors use the score to judge how well the liver is working, mainly in people with liver cancer or cirrhosis. It needs no scan or biopsy, and it does not diagnose liver disease or cancer on its own.
What Is a Good ALBI Score?
Your care team decides what counts as good for you. A score is only useful when it is tied to a decision, such as whether surgery is safe or which treatment fits your liver. This page does not give grade cutoffs, and the typical lab ranges for albumin and bilirubin are not ALBI cutoffs. Ask your doctor which grade you have, how it was worked out, and how it affects your plan.
Can I Calculate My Own ALBI Score?
You should not act on a self-calculated result. The number depends on exact lab values and the formula your clinic uses, and labs can differ slightly in their reference ranges. Your doctor reads the score together with your symptoms, imaging, and other tests. If you want to understand your result, ask your care team to walk you through it. If an albumin or bilirubin result is abnormal, talk with your doctor rather than trying to interpret it alone.
Is the ALBI Score the Same as the Child-Pugh Score?
No. ALBI uses only albumin and bilirubin. Child-Pugh also counts other findings, such as clotting and complications of cirrhosis like fluid in the abdomen, and it sorts people with cirrhosis into class A, B, or C. Both can be used to assess liver function before HCC surgery, and MELD is another option. None of them stands alone. Your team also considers portal hypertension, imaging, the size and position of any tumor, and your overall health.
Does a Poor ALBI Score Mean I Cannot Have Treatment?
Not necessarily. Treatment choices depend on the stage of the cancer, liver function, and overall health. Lower liver function may change which options fit best, and some medicines are used only when liver function is adequate. One result is also just a snapshot, so your team may repeat tests to see the trend. Talk with your liver team about your choices and what each one would involve.
How Can I Support My Liver Function?
Avoid alcohol, keep your follow-up visits, and take medicines as directed. Keeping your lab appointments lets your team see how albumin and bilirubin change over time, since they can shift with illness, nutrition, and medicines. Eat small, regular meals with enough protein unless your team advises otherwise, and ask a dietitian about a light late-evening snack. Call your care team promptly if you notice yellowing of the skin or eyes, new swelling, or new confusion.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.