UCL Division of Medicine


Health Innovation Challenge Fund

19 December 2013

 Dr Alastair O’Brien has received £1.6 million from the Health Innovation Challenge Fund (joint Wellcome Trust & Department of Health) for ATTIRE (Albumin To prevenT Infection in chronic liveR failure). This is to fund a multi-centre clinical phase II and phase III trial at >15 sites that will examine whether administration of albumin to patients with liver failure in order to increase plasma levels to near normal will prevent hospital acquired infection. The clinical research network (LCRN) will fund the research nurse costs (>£1million). Over 100,000 patients are admitted to hospital every year with advanced liver cirrhosis and infection is their most common problem. Dr O’Brien and his team have shown that in these patients leukocyte function is markedly impaired by an up regulation of the hormone Prostaglandin E2 and infusion of albumin can reverse this process by binding and neutralising its effects. Albumin is widely considered to be beneficial in infection by hepatologists but until now there was no putative mechanism and therefore no consensus as to how to prescribe it. They wish to repurpose it as an immune restorative drug to improve leukocyte function in patients with advanced cirrhosis and therefore improve their ability to fight off infection.  It is hoped to demonstrate that its use will lead to reduced nosocomial infection rates, mortality and length of stay and thereby reduce health care costs.