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ALBI Grade (Albumin-Bilirubin)

The ALBI score = 0.66 × log₁₀(bilirubin µmol/L) − 0.085 × albumin (g/L) grades liver function, particularly in hepatocellular carcinoma. Grade 1 ≤ −2.60, grade 2 > −2.60 to ≤ −1.39, grade 3 > −1.39.

Total bilirubin (mg/dL or µmol/L)
Serum albumin (g/dL or g/L)

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Interpretation

Result	Meaning
≤ −2.60	Grade 1
> −2.60 to ≤ −1.39	Grade 2
> −1.39	Grade 3

Formula

ALBI = 0.66 × log₁₀[bilirubin (µmol/L)] − 0.085 × albumin (g/L)

Clinical pearls

Objective alternative to Child-Pugh: no subjective ascites or encephalopathy grading.
Grade 2 is often split into 2a/2b at −2.27 (mALBI).

Examples

albi bili 17 umol/L albumin 40 g/L ALBI grade for bilirubin 1.2 mg/dL and albumin 3.2 g/dL albi bili 3 alb 2.5

FAQ

ALBI or Child-Pugh?

ALBI uses only bilirubin and albumin, avoids subjective items and separates Child-Pugh A patients into distinct prognostic groups.

Evidence

Johnson PJ et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. J Clin Oncol 2015;33:550–8.

Hepatology & GI · Reviewed 2026-10-14 · Methodology