Participant Inclusion Criteria

•All patients admitted to hospital with acute onset or worsening of complications of cirrhosis
•Over 18 years of age
•Predicted hospital admission > 5 days (at trial enrolment), which must be within 72 hours of admission
•Serum albumin <30g/l at screening
•Documents informed consent to participate (or consent given by a legal representative)

Participant Exclusion Criteria

•Advanced hepatocellular carcinoma with life expectancy of less than 8 weeks
•Patients who will receive palliative treatment only during their hospital admission
•Known or suspected severe cardiac dysfunction
•Any clinical condition which the investigator considers would make the patient unsuitable for the trial
•The patient has been involved in a clinical trial of Investigational Medicinal Products (IMPs) within the previous 30 days that would impact on their participation in    this study (approval from CIs of both studies required).
•Trial investigator unable to identify the patient (by NHS number)

Randomisation will take into account the following criteria:

Patients in the feasibility study will not be randomised BUT their details will still need to be entered into in order to generate an individual patient identifier. 

For full guidance please see                                 For randomisation please go to:

Screening & Randomisation

​​​​ATTIRE Randomised Clinical Trial