Changes of serum bilirubin fraction in postoperative liver failure cases treated by plasmapheresis: an effective marker for evaluation of bilirubin removal.
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.
Usami
M
M
First Department of Surgery, Kobe University School of Medicine, Japan.
Nishimatsu
S
S
Ohyanagi
H
H
Shiroiwa
H
H
Takeyama
Y
Y
Kasahara
H
H
Saitoh
Y
Y
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*
D001663:Bilirubin