Human serum bilirubin fractionation in various hepatobiliary diseases by the newly developed high performance liquid chromatography.

Serum Bilirubin was fractionated by newly developed reversed phase high performance liquid chromatography (HPLC) into 5 fractions: delta (delta-Bilirubin, B delta), gamma (bilirubin diglucuronide, BDG), beta (Bilirubin monoglucuronide, BMG), beta' ((Z, E,)- and/or (E, Z)-bilirubin IX alpha) and alpha ((Z, Z)-bilirubin IX alpha). Sera of healthy subjects and of patients with unconjugated hyperbilirubinemia showed predominantly alpha fraction with a small amount of beta' fraction. Trace amounts of delta fraction were detected in a few cases. The results of fractionation of serum bilirubin in 159 patients with various hepatobiliary diseases suggested that the ratios B delta/(B delta + BDG + BMG) and BMG/B delta can be useful parameters to follow patients with jaundice, compared with the reported B delta/total bilirubin which did not always reflect the jaundice stage, especially in cases with low serum bilirubin levels.