Effect of plasma exchange on patients with refractory hyperbilirubinemia

Plasma exchange has been employed in many fields. We reviewed its effect in 5 cases of refractory hyperbilirubinemia after acute liver dysfunction excluding fulminant hepatitis. Three liters of plasma replacement per session of plasma exchange was sufficient to remove bilirubin from the plasma effectively, but plasma exchange over a period of 3 consecutive days was needed to remove bilirubin from the whole body. In cases of a serum total bilirubin concentration of above 30mg/dl, the effect was less and far more plasma exchange was required. Posttransfusional hepatitis occurred in a few cases. Although plasma exchange certainly represents the most effective method for reducing the bilirubin levels, further studies on the effects of plasmaperfusion are needed since with this procedure post-transfusional hepatitis never occurs.