Healthcare & Clinical Calculations
ALBI (Albumin-Bilirubin) Score & Grade 1–3 Liver Reserve Calculator
Calculate Philip Johnson’s objective Hepatocellular Carcinoma (HCC) liver reserve score ALBI = (LOG10(Bilirubin_umolL) * 0.66) + (Albumin_gL * -0.085) and stratify ALBI Grade 1 (<= -2.60), Grade 2, and Grade 3 (> -1.39).
Eliminate subjective ascites/encephalopathy grading inside Child-Pugh A oncology cohorts!
Nearly 70–80% of Hepatocellular Carcinoma (HCC) patients entering resection, TACE, SBRT, or systemic immunotherapy (atezolizumab-bevacizumab / lenvatinib) fall into broad "Child-Pugh Class A"—yet survival inside Child-Pugh A varies two- to threefold! Worse, Child-Pugh relies on subjective clinical grading of ascites and encephalopathy plus arbitrary ceiling cutoffs.
Philip J. Johnson et al. (Journal of Clinical Oncology 2015) derived a purely objective, continuous two-lab linear predictor from serum Total Bilirubin (umol/L; multiply mg/dL by 17.104) and Albumin (g/L; multiply g/dL by 10): ALBI = (LOG10(Bilirubin_umolL) * 0.66) + (Albumin_gL * -0.085)! Validated cutoffs split hepatic reserve into ALBI Grade 1 (<= -2.60, preserved synthetic reserve), ALBI Grade 2 (-2.60 < ALBI <= -1.39, intermediate reserve), and ALBI Grade 3 (> -1.39, decompensated reserve)! Compare Bilirubin = 42 umol/L, Albumin = 31 g/L -> ALBI = -1.564 (Grade 2) against preserved Bilirubin = 14 umol/L, Albumin = 43 g/L -> ALBI = -2.899 (Grade 1)!
| Hepatic Lab Profile (SI Units) | Linear ALBI Score | ALBI Grade Cutoff | HCC Oncology Implication |
|---|---|---|---|
| Preserved Reserve (Bili 14 umol/L, Alb 43 g/L) | -2.899 | ALBI Grade 1 (<= -2.60) | Best Resection / Systemic Survival |
| Intermediate Reserve (Bili 42 umol/L, Alb 31 g/L) | -1.564 | ALBI Grade 2 (-2.59 to -1.39) | Monitor Post-TACE / TKI Decompensation |
| Advanced Dysfunction (ALBI > -1.39) | > -1.39 | ALBI Grade 3 (> -1.39) | High Hepatic Failure Toxicity Risk |
Continuous Objective ALBI Score = (LOG10(Bilirubin_umolL) * 0.66) - (0.085 * Albumin_gL)
Evaluates Johnson (2015) formula from Bilirubin in umol/L (B2) and Albumin in g/L (B3).
=IF(OR(B2 <= 0, B3 <= 0), "Invalid Bilirubin / Albumin", ROUND((LOG10(B2) * 0.66) + (B3 * -0.085), 3))ALBI Hepatic Reserve Grade (Grade 1, Grade 2, or Grade 3)
Stratifies unrounded ALBI score across <= -2.60 (Grade 1), <= -1.39 (Grade 2), and > -1.39 (Grade 3).
=IF(OR(B2 <= 0, B3 <= 0), "Invalid Bilirubin / Albumin", IF(((LOG10(B2) * 0.66) + (B3 * -0.085)) <= -2.6, "ALBI Grade 1 (<= -2.60) — Well-Preserved Hepatic Reserve", IF(((LOG10(B2) * 0.66) + (B3 * -0.085)) <= -1.39, "ALBI Grade 2 (-2.59 to -1.39) — Intermediate Hepatic Reserve", "ALBI Grade 3 (> -1.39) — Decompensated Hepatic Reserve")))Try the example
Use the original values or change them to test your understanding.