A novel COMBinATorial therapy with albumin and enoxaparin inpatients with decompensated cirrhosis at high-risk of poor outcome(COMBAT trial).

A 90-patient clinical trial will test whether combining human albumin with the blood thinner enoxaparin can prevent liver disease patients from rapidly deteriorating after a hospital discharge. This matters because patients with decompensated cirrhosis—a late stage of liver scarring where the organ can no longer function properly—face a high risk of death or needing a liver transplant within months of leaving hospital. Current standard medical therapy does little to alter that trajectory. The trial specifically targets patients with a CLIF-C AD score of 50 or higher, a marker of imminent poor outcome, and randomises them to receive either standard care alone or standard care plus the two-drug combination for up to 90 days. If the combinatorial therapy proves safe and effective, it could become a straightforward, low-cost addition to post-discharge care for high-risk cirrhosis patients. That would directly reduce deaths and liver transplant waiting lists, without requiring new infrastructure or specialist equipment—just a change in prescribing practice. The trial also tracks exploratory biological markers, which may reveal why some patients respond and others do not, guiding future treatment refinements.