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

Andrea B. Schreuder, Jana Vanikova, Libor Vitek, Rick Havinga, Charles E. Ahlfors, Christian V. Hulzebos, Henkjan J. Verkade*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

6 Citaten (Scopus)
224 Downloads (Pure)

Samenvatting

Background: Severe unconjugated hyperbilirubinemia carries the risk of neurotoxicity. Phototherapy (PT) and exchange transfusion (ET) are cornerstones in the treatment of unconjugated hyperbilirubinemia. Studies to improve ET efficacy have been hampered by the low application of ET in humans and by the lack of an in vivo model. The absence of an appropriate animal model has also prevented to determine the efficacy of adjunct or alternative treatment options such as albumin (Alb) administration.

Aim: To establish an in vivo model for ET and to determine the most effective treatment (combination) of ET, PT and Alb administration.

Methods: Gunn rats received either PT, PT+Alb, ET, ET+PT, ET+PT+Alb or sham operation (each n = 7). ET was performed via the right jugular vein in similar to 20 min. PT (18 mu W/cm(2)/nm) was started after ET or at T-0. Albumin i.p. injections (2.5 g/kg) were given after ET or before starting PT. Plasma unconjugated bilirubin (UCB), plasma free bilirubin (Bf), and brain bilirubin concentrations were determined.

Results: We performed ET in 21 Gunn rats with 100% survival. At T-1, ET was profoundly more effective in decreasing both UCB -44%, p

Conclusions: We optimized ET for severe unconjugated hyperbilirubinemia in the Gunn rat model. Our data indicate that ET is the most effective treatment option, in the acute as well as the follow-up situation.

Originele taal-2English
Artikelnummere77179
Aantal pagina's6
TijdschriftPLoS ONE
Volume8
Nummer van het tijdschrift10
DOI's
StatusPublished - 15-okt-2013

Citeer dit