Human serum albumin has been widely used in an array of clinical settings for nearly 7 decades. Although there is no evidence to support the use of albumin rather than crystalloid in acute volume resuscitation, many clinicians continue to use albumin because it has other important physiologic effects besides the oncotic function. In keeping with the improved understanding of albumin physiology and pathophysiology of many acute and chronic diseases, use of albumin for medical applications has increased in recent years. This, along with increased costs of manufacturing and lower production volume of medical-grade albumin, has lead to an ongoing shortage and rapid increase in albumin prices. This review is based on the analysis of major publications, related to albumin chemistry, physiology, and medical uses including guidelines developed by professional and governmental organizations. Results reflect current knowledge about the role of albumin in health and disease and relevance of albumin therapy in specific clinical settings. Albumin therapy is currently recommended in spontaneous bacterial peritonitis with ascites, refractory ascites not responsive to diuretics, large-volume paracentesis, post-paracentesis syndrome, and the treatment of hepatorenal syndrome as an adjunct to vasoconstrictors. New indications for albumin therapy are linked to the antioxidant activity of albumin and its effects on capillary integrity. In recent years, large-pore hemofiltration and albumin exchange have emerged as promising liver support therapies for liver failure and other toxic syndromes. They are designed to remove a broad range of blood-borne toxins and to restore normal functions of the circulating albumin by replacing defective forms of albumin and albumin molecules saturated with toxins with normal albumin. In view of the ongoing worldwide shortage and high cost of human albumin (native and recombinant), new usage criteria, protocols, and guidelines for appropriate utilization of albumin are needed.

Background: Patients with end-stage renal disease undergoing haemodialysis experience numerous life changes often requiring significant sacrifices. Adaptation to the limitations associated with the disease and dialysis treatments may influence their health behaviour. Aim: The aim of the study was to analyse the relationship between the level of illness acceptance and the intensity of health behaviours in patients treated with haemodialysis. Methods: The study used a diagnostic survey method using the Acceptance of Illness Scale and Health Behaviour Inventory questionnaires, adapted to Polish conditions by Z. Juczyński. The study was conducted from December 2022 to March 2023 among 105 patients in one dialysis centre in Poland. Results: The patients showed an average level of disease acceptance (22.64 ± 6.52) and presented a low level of health behaviour intensity (79.11 ± 12.46). The disease acceptance index and the intensity of health behaviours showed positive correlations with age, disease duration, and the duration of haemodialysis treatment. Statistically significant positive correlations were identified between illness acceptance and the intensity of health-related behaviours. Conclusions: The acceptance of illness may influence adherence to health behaviours, which highlights the importance of introducing integrated and early therapeutic support to assist in the acceptance process.

Background/Objectives: Readiness for hospital discharge after kidney and liver transplantation is a complex process influenced not only by clinical factors but also by psychological and social aspects. This cross-sectional, analytical study aimed to assess discharge readiness and examine the psychological and social factors affecting patients’ preparations for leaving the hospital among renal and liver transplant recipients. Methods: A diagnostic survey was conducted using standardized questionnaires, including assessment of readiness for discharge (based on Canadian Health Outcomes for Better Information and Care-C-HOBIC), Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), and Resilience Measurement Scale (SPP-25). The collected data were analyzed using IBM SPSS Statistics version 28. The study included 117 recipients (31.6% liver, 68.4% kidney) who received transplants at centers in Poland between February and May 2025. Results: The average discharge readiness score was 34.51 ± 5.37. Overall, 79.5% of respondents had high discharge readiness, while 20.5% reported moderate readiness. A multiple regression model with eight predictors (SPP-25, HADS-depression, HADS-anxiety, Friends, Family, Significant person, Knowledge of self-care, Communication and information support) was statistically significant (F(8,108) = 11.629, p < 0.001), explaining 46.3% of the variance in discharge readiness (R² = 0.463; adjusted R² = 0.423). Knowledge of self-care emerged as the strongest predictor (B = 0.475, β = 0.577, t = 5.424, p < 0.001), followed by psychological resilience (SPP-25) (B = 0.011, β = 0.221, t = 2.381, p = 0.019). Other variables were not significant predictors (p > 0.05). Conclusions: Discharge readiness after kidney and liver transplantation is significantly affected by patients’ self-care knowledge and psychological resilience, highlighting the importance of education and psychological support in preparing patients for discharge.

Wprowadzenie: Przeszczep nerki i wątroby to procedury ratujące życie, jednak długoterminowe wyniki zależą od zdolności biorców do skutecznej samopielęgnacji. Edukacja pacjentów jest podstawowym elementem przygotowania do wypisu ze szpitala i opieki po przeszczepie. Cel pracy: Celem badania było ocenienie wpływu edukacji terapeutycznej na gotowość do wypisu wśród biorców przeszczepów nerek i wątroby oraz wypracowanie praktycznych zaleceń dla programów edukacyjnych. Materiał i metody: Badanie obejmowało 117 dorosłych biorców (31,6% z wątroby, 68,4% z nerek), którzy przeszli transplantację w kilku polskich ośrodkach transplantacyjnych w okresie od lutego do maja 2025 roku. Przeprowadzono badanie diagnostyczne za pomocą kwestionariusza gotowości do wypisu z zestawu C-HOBIC, uzupełnionego o pytania dotyczące cech pacjentów, procesów edukacyjnych oraz edukatorów. Dane zostały poddane analizie statystycznej przy użyciu IBM SPSS Statistics (v. 28). Wyniki i wnioski: Edukacja terapeutyczna prowadzona przed i po transplantacji znacząco poprawiła gotowość pacjentów do wypisu. Edukacja realizowana przez lekarzy, pielęgniarki, koordynatorów transplantacyjnych i dietetyków miała pozytywny wpływ na ogólną gotowość i wiedzę pacjentów w kluczowych obszarach, takich jak farmakoterapia, rozpoznawanie objawów, postępowanie w nagłych przypadkach i samoopieka. Edukacja prowadzona przez psychologów nie wykazała istotnego wpływu. Wśród strategii samokształcenia, jedynie czytanie literatury medycznej było istotnie powiązane z lepszym przygotowaniem do przestrzegania zaleceń i podejmowania codziennej aktywności fizycznej. Wnioski: Edukacja terapeutyczna prowadzona przez interdyscyplinarny zespół opiekuńczy odgrywa kluczową rolę w przygotowaniu biorców transplantacji do wypisu. Skuteczne programy edukacyjne powinny być zorganizowane na różnych etapach opieki, dostosowane do potrzeb pacjentów i wspierane przez ukierunkowane działania samokształceniowe, które wspomogą długoterminową adherencję i kompetencje w samodzielnym zarządzaniu zdrowiem.