The role of plasma exchange in hyperbilirubinemia from a different perspective

Abstract

Objective: In this retrospective study, we aimed to present our experience of managing hyperbilirubinemia. Method: Twenty three patients with hyperbilirubinemia who received apharesis treatment between 2006 and 2017 at the apheresis unit of Cumhuriyet University School of Medicine were included in the study. Records of the patients were evaluated retrospectively and the following data were collected: patient’s age, sex, presenting symptoms, number of plasma exchange, adjuvant treatment modalities, use of replacement fluid, treatment outcomes, and plasma exchange complications . Results: The median age of the patients was 57 years (range; 18-82). The median number of plasma exchange was 5,5 (range; 1-25). Fresh frozen plasma was the only replacement fluid used. There was significant statistical differences between pre- and post-plasma exchange bilirubine levels (p<0.05). Toxic hepatitis was the most common cause of hyperbilirubinemia in our patient population. In addition to plasma exchange, patients were treated with proper treatment of the underlying condition. We observed allergic reactions 2 (8.69%) patients and hypotension in 3 (13%) patients as complications Conclusions: Plasma exchange is a safe method for the elimination of bilirubin. However, diminishing hyperbilirubinemia with plasma exchange together with the proper treatment of the underlying condition should be the primary goal in management.