Albumin-Bilirubin Grade (ALBI Score)

Many patients who are Child-Pugh A are actually ALBI Grade 2. These patients have significantly worse outcomes after liver resection than ALBI Grade 1 patients.

If the patient has an acute liver flare (e.g., from HBV), the ALBI score will be falsely high. Re-calculate the score once the bilirubin has stabilized.

Use the ALBI grade within each BCLC stage to further refine the prognosis and tailor treatment intensity.

Developed by an international group led by Professor Philip Johnson. It was a direct response to the frustration with the Child-Pugh score, which was originally developed for esophageal varices surgery, not cancer management.

ALBI was derived using data from Europe, USA, Japan, and China, making it one of the few liver scores that is truly validated across different ethnicities and HCC etiologies.