Ott R, Rupprecht H, Born G, Müller V, Reck T, Hohenberger W, Köckerling F
Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Transplantation. 1998 Feb 15;65(3):434-7. doi: 10.1097/00007890-199802150-00025.
Severe hyperbilirubinemia is known to exert multiple toxic effects. Thus, a reduction in bilirubin by use of various adsorbent columns has been reported for a variety of hepatic disorders, but no experience with liver transplant patients is available as yet.
Plasma separation and bilirubin adsorption by an anion-exchange adsorbent column (BR-350) were performed in two patients with severe jaundice (total serum bilirubin > 55 mg/dl) and multiple organ failure that had developed after orthotopic liver transplantation.
The procedure resulted in an 18% to 35% reduction in total bilirubin after each session, accompanied by a remarkable clinical improvement. Both patients finally recovered and had a favorable outcome. No complications or side effects of bilirubin adsorption were observed during any of the six sessions.
Bilirubin adsorption is a safe and effective treatment. It should be considered as supportive therapy for excessive hyperbilirubinemia after liver transplantation. In selected cases, retransplantation may thus be avoided.
已知严重高胆红素血症会产生多种毒性作用。因此，已有报道称使用各种吸附柱降低胆红素可用于多种肝脏疾病，但目前尚无肝移植患者的相关经验。
对两名原位肝移植后出现严重黄疸（血清总胆红素>55mg/dl）和多器官功能衰竭的患者，采用阴离子交换吸附柱（BR-350）进行血浆分离和胆红素吸附。
每次治疗后总胆红素降低18%至35%，同时临床症状明显改善。两名患者最终均康复且预后良好。在六次治疗过程中均未观察到胆红素吸附的并发症或副作用。
胆红素吸附是一种安全有效的治疗方法。应将其视为肝移植后严重高胆红素血症的支持性治疗。在某些选定的病例中，因此可避免再次移植。
