AIM To evaluate the safety and efficacy of bilirubin adsorption in the treatment of hyperbilirubinemia after cardiac surgery.
METHODS Eleven patients with hyperbilirubinemia and acute liver failure after cardiac surgery whose were treated with bilirubin adsorption between Jan. 2017 to Dec. 2018 were retrospectively analyzed. Basic diseases, names of heart operation, cardiopulmonary bypass times, and the changes of liver function, bilirubin and coagulation index before and after treatment were recorded.
RESULTS Among the 11 patients, 7 were males and 4 were females, with an average age of (45 ± 13) years and a mean cardiopulmonary bypass time of (226 ± 104) min. After bilirubin adsorption, serum total bilirubin decreased from (409 ± 137) μmol/L to (298 ± 107) μmol/L(P<0.05), and serum direct bilirubin decreased from (321±100) μmol/L to (166±111) μmol/L(P<0.01). Transaminase, serum total protein, albumin, INR, platelet count, white blood cell count, hemoglobin, urea nitrogen, creatinine had no statistical difference between before and after treatment, (P > 0.05). In 11 patients, bilirubin adsorption was treated 22 sessions, 8 patients were treated 1 session, and 3 patients were treated 2 sessions, 5 sessions, and 7 sessions respectively. The decrease rate of serum total bilirubin was 2.8% ~ 47.6%. 4 patients survived, 7 patients died, and the survival rate was 36%. No treatment-related side effects happened during the treatment.
CONCLUSION The bilirubin adsorption is effective and safe in the treatment of acute liver failure after cardiac surgery.
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