title: Changes of serum bilirubin fraction in postoperative liver failure cases treated by plasmapheresis: an effective marker for evaluation of bilirubin removal.
abstract: Utility of a new method of bilirubin fractionation was evaluated in monitoring the effectiveness of plasma exchange (PE) performed in 10 postoperative cases with liver failure. Fractionation of serum bilirubin by high-performance liquid chromatography demonstrated a higher delta bilirubin (B delta) peak against lower conjugated bilirubin peaks [monoconjugated bilirubin (MCB) and diconjugated bilirubin (DCB)] in the three recovered cases. The calculated ratio of MCB/B delta and the ratio of B delta/(MCB + DCB + B delta) in the recovered cases showed statistically significant different against seven unrecovered cases (p less than 0.01). These results suggest that the recovered cases had a different quality hyperbilirubinemia and a different disease entity before PE as well as a different response to PE, and this novel method for serum bilirubin subfraction is considered a useful marker in selecting a patient responsive to PE.
authors.affiliation: First Department of Surgery, Kobe University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Usami
authors.forename: S
authors.initials: S
authors.lastname: Nishimatsu
authors.forename: H
authors.initials: H
authors.lastname: Ohyanagi
authors.forename: H
authors.initials: H
authors.lastname: Shiroiwa
authors.forename: Y
authors.initials: Y
authors.lastname: Takeyama
authors.forename: H
authors.initials: H
authors.lastname: Kasahara
authors.forename: Y
authors.initials: Y
authors.lastname: Saitoh
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011183:Postoperative Complications / Q000628:therapy*
chemical_list: D001663:Bilirubin