For healthcare professionals
ALBI score calculator
The ALBI (albumin-bilirubin) score grades liver function from two blood tests. Grade 1 is a score of -2.60 or lower, grade 2 is above -2.60 to -1.39, and grade 3 is above -1.39. Johnson and colleagues introduced it in 2015 for patients with hepatocellular carcinoma. This calculator is written for clinicians and is not a diagnosis.
Laboratory values
Nothing you enter leaves this page.
What you will see
The ALBI score, how it was worked out, and the ALBI grade from 1 to 3.
Educational only, not medical advice. Not a diagnosis. Treatment decisions belong to the treating team.
Source
Johnson PJ and colleagues, Journal of Clinical Oncology 2015. The formula, the grade cut points and the modified 2a and 2b split are taken from open-access (CC BY 4.0) papers: Iino and colleagues, Cancers 2026, and Makino and colleagues, Medical Sciences 2026 (bilirubin unit conversion). The tests check the formula, every grade edge and the unit conversions.
Validated in
Introduced in a large international study of patients with hepatocellular carcinoma to relate liver function to survival after treatment (Nguyen 2026). It has since been studied in cirrhosis and in other conditions, but the grades were set in liver cancer.
Limits
ALBI uses only albumin and bilirubin. It leaves out ascites, encephalopathy and clotting, which the Child-Pugh score includes. Unit conversions on this page are arithmetic and are not part of the published score.
Formula
ALBI score = (log10 total bilirubin in umol/L x 0.66) + (albumin in g/L x -0.085) (Iino 2026). The original paper is by Johnson and colleagues (Johnson 2015).
Worked example: bilirubin 10 umol/L and albumin 40 g/L give 1 x 0.66 + 40 x -0.085 = 0.66 - 3.40 = -2.74, grade 1.
For laboratory values in US units, 1 mg/dL of bilirubin is 17.1 umol/L (Makino 2026), and albumin in g/dL is multiplied by 10 to give g/L.
Grades
| ALBI score | ALBI grade | Modified ALBI |
|---|---|---|
| -2.60 or lower | 1 | 1 |
| above -2.60 to -2.27 | 2 | 2a |
| above -2.27 to -1.39 | 2 | 2b |
| above -1.39 | 3 | 3 |
Source: Iino and colleagues 2026 (Iino 2026). A lower (more negative) score means better liver function.
Where it is used
Johnson and colleagues introduced the ALBI score in a large international study of liver function in hepatocellular carcinoma, as a simpler measure than the Child-Pugh score (Nguyen 2026). It was first set up to assess liver reserve in hepatocellular carcinoma and has since been studied as a marker in other cancers (Makino 2026).
Related calculators
To grade cirrhosis with ascites and encephalopathy included, use the Child-Pugh score calculator. For end-stage liver disease, see the MELD score calculator. Other bedside scores are listed under For healthcare professionals.
Sources
- Iino C, Abe T, Endo K, et al. Baseline host biomarkers and six-month sustained drug-free status after atezolizumab-bevacizumab for hepatocellular carcinoma: exploratory clinical stratification using PAN-DF score. Cancers (Basel). 2026;18(20):3366. doi:10.3390/cancers18203366. PMID 42938898. Open access (CC BY 4.0). Methods: ALBI formula, grades 1 to 3 and modified grades 2a and 2b. pmc.ncbi.nlm.nih.gov/articles/PMC13702456/
- Makino T, Izumi K, Nakagawa R, et al. Prognostic value of a novel risk score combining psoas muscle density and ALBI grade in localized renal cell carcinoma. Med Sci (Basel). 2026;14(5):509. doi:10.3390/medsci14050509. PMID 42783382. Open access (CC BY 4.0). ALBI formula, bilirubin 1 mg/dL = 17.1 umol/L, origin in hepatocellular carcinoma. pmc.ncbi.nlm.nih.gov/articles/PMC13609120/
- Nguyen TD, Lam HT, Vo TD. The value of the ALBI and ALBI-PLT scores in predicting esophageal varices in cirrhotic patients: a cross-sectional study. Health Sci Rep. 2026;9(8):e72892. doi:10.1002/hsr2.72892. PMID 42504234. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC13401716/
- Johnson PJ, Berhane S, Kagebayashi C, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach, the ALBI grade. J Clin Oncol. 2015;33(6):550-558. doi:10.1200/JCO.2014.57.9151. PMID 25512453. Original paper (cited; the formula and grades used here are taken from Iino 2026, CC BY). doi.org/10.1200/JCO.2014.57.9151
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.