In Vivo and In Vitro Evaluation of Bilirubin Removal in Postoperative Hyperbilirubinemia Patients

Abstract

The effect of plasma adsorption (PA) on bilirubin removal by a porous type anion exchange resin (Medisorba BL, Kuraray) was evaluated in vitro PA and in vivo PA and plasma exchange (PE) in postoperative hyperbilirubinemia patients. Serum and plasma bilirubin were measured by routine biochemical tests, fractionated by high-performance liquid chromatography, and its reduction and rebound were compared. In vitro and in vivo PA indicated the selectivity in bilirubin removal against measured molecules. Changes in bilirubin fractions after PA showed higher adsorbance of conjugated bilirubin (21.4-30.8%) and less adsorbance of delta (85.7%) and unconjugated bilirubin (73.7%). These differences were not observed after PE. But rebound of serum total bilirubin levels after PA was more than that after PE. It is suggested that PA by the resin is selective and has a different metabolic effect on bilirubin during and after PA as compared with PE.