Question

would a patient with severe liver failure can expect to high albumin in the blood stream or low

Answer 1

A patient with severe liver failure will have low albumin in the blood stream.

Liver is the main site for the synthesis of albumin. So if there is severe liver failure (advanced cirrhosis) then there will be impaired function of hepatocytes since they are damaged. This will lead to decrease in synthesis of albumin by hepatocytes. There is also sodium & water retention in severe liver failure that dilutes the content of albumin in extracellular space.

Since the synthesis is decreasing and concentration of albumin also decreasing due to dilution caused by excess sodium and water retention. So a patient with severe liver failure will have hypoalbuminemia i.e. low albumin in the blood.