Beyond plasma bilirubin: The effects of phototherapy and albumin on brain bilirubin levels in Gunn rats

Optimizing Exchange Transfusion for Severe Unconjugated Hyperbilirubinemia: Studies in the Gunn Rat

“…We speculated that HSA and PT work in tandem : HSA binds bilirubin within the plasma, and PT then promotes its excretion via the bile [11]. In this study we showed that albumin administration in combination with either PT or ET is already effective after 1 h of treatment.…”

“…Recently, we found that HSA enhances the efficacy of routine PT in phototherapy-treated Gunn rats, both during permanent and acute jaundice [11]. We speculated that HSA and PT work in tandem : HSA binds bilirubin within the plasma, and PT then promotes its excretion via the bile [11].…”

“…In a previous study in adult Gunn rats, we showed that HSA readily enters the plasma compartment after i.p. injections [11]. It is worth mentioning that in this previous study we have applied “albumin only” treatment, i.e.…”

“…Two phototherapy devices were developed according to the prototype that was designed by Ostrow et al and previously successfully used [11], [17]. Each device consisted of two blue phototherapy lamps (Philips, TL-20W/52) suspended in a reflective canopy 30 cm above the bottom of the cage.…”

“…For example, albumin infusion might be a good treatment modality. Recently, we found that adjunct human serum albumin (HSA) increased the efficacy of PT; it decreased plasma Bf concentrations and brain bilirubin levels by ∼90% and ∼70%, respectively [11]. Studies to replace ET, to improve ET efficacy and/or to minimize its risks have been hampered by the contemporary low application rate of ET in humans and by the lack of an appropriate in vivo model system.…”