In vivo Hemoperfusion Studies of Bilirubin Removal from Jaundiced Dogs

Abstract

Removal of bilirubin by hemoperfusion (HP) on a macroreticular ion-exchange resin is suggested as a novel clinical procedure for the treatment of jaundiced newborn babies. The efficiency and biocompatibility of the proposed macroreticular (MR) ion exchange column was tested in vivo with jaundiced dogs. An animal model with a choledocho-suprarenal vein shunting allowed to test the column capacity for the adsorption of conjugated and unconjugated bilirubin. A second animal model, based on infusing unconjugated bilirubin directly into the blood stream, enabled to test the column operation at desired unconjugated bilirubin concentrations. The results of the in vivo hemoperfusion tests are very encouraging and compare favorably with bilirubin removal from babies by exchange transfusion (ET). Operating a column containing 10 ml resin per kg body weight for 3 hours removed over 1.7 times the initial unconjugated bilirubin content. Furthermore, the animals seemed to be unaffected by the HP procedure; the changes due to hemoperfusion on blood chemistry, hematology and some hormone levels were practically insignificant.