Geiger H, Klepper J, Lux P, Heidland A
IV Medical Clinic, University of Erlangen-Nürnberg, Germany.
Int J Artif Organs. 1992 Jan;15(1):35-9.
We investigated the efficacy of an anion-exchange adsorbent column (ASAHI BR-350, DIAMED) for removal of bilirubin and bile acids in five patients with intractable jaundice of various origin. Four litres of plasma were separated by membrane plasma separation (Plasmaflow OP-05) at a rate of 22.5 ml/min. The plasma was then perfused through an anion exchange adsorbent and returned to the venous blood line of the plasma separation. In some of the patients this procedure was combined with regular hemodialysis treatment. The concentration of total bilirubin was cut by 31 to 60%; total bile acids were reduced by 20 to 74%. Three patients recovered and had a favourable outcome. Two patients died despite the bilirubin adsorption treatment. The effects of the adsorbent column on specific blood parameters, including the coagulation system, were measured. Our data suggest that bilirubin adsorption should be examined further as a treatment for critically ill patients with intractable jaundice.
我们研究了阴离子交换吸附柱（旭化成BR-350，迪亚美）对5例各种病因所致顽固性黄疸患者胆红素和胆汁酸的清除效果。通过膜血浆分离法（血浆流量OP-05）以22.5 ml/分钟的速度分离出4升血浆。然后将血浆灌注通过阴离子交换吸附剂，再返回至血浆分离的静脉血路。部分患者该操作与常规血液透析治疗相结合。总胆红素浓度降低了31%至60%；总胆汁酸减少了20%至74%。3例患者康复且预后良好。2例患者尽管接受了胆红素吸附治疗仍死亡。我们测定了吸附柱对包括凝血系统在内的特定血液参数的影响。我们的数据表明，对于患有顽固性黄疸的危重症患者，胆红素吸附作为一种治疗方法应进一步研究。
