The role of plasma exchange in hyperbilirubinemia from a different perspective

Abstract

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.

The Role of Plasmapheresis in Severe Leptospirosis Refractory to Standard Therapy: A Case Report and a Comprehensive Literature Review

“…The optimal goal for reducing bilirubin levels following TPE remains unclear. Previous research has shown diverse outcomes, with reductions of 46.53%, 21.20%, and 37.69% observed in bilirubin levels after TPE [ 15 ].…”

Hyperbilirubinemia 73 mg/dl after Acute Suppurative Cholangitis is not always ‎Fatal, a Case Report

“…In fact, plasmapheresis or ultrafiltration was tried in treatment of severe hyperbilirubinemia in the centers lacking the facility of artificial ad bioartificial liver support. Novelli tried plasma ultrafiltration to treat patients with high serum bilirubin awaiting liver transplantation [15] and also it was tried in patients with cholestasis with variable rates of success [7]. To the best of our knowledge, this is the first case of ultrafiltration in managing acute suppurative cholangitis with this exceptionally high level of serum bilirubin.…”