Bilirubin removal via extracorporeal adsorption

Bilirubin removal via extracorporeal adsorption refers to the use of blood purification techniques, such as plasma adsorption perfusion or hemoadsorption, to physically clear bilirubin from the bloodstream in patients suffering from severe hyperbilirubinemia due to liver failure or other causes. Because a large fraction of bilirubin is bound to albumin and cannot be removed by standard dialysis, specialized adsorbent cartridges—often composed of synthetic polymers—selectively bind and remove bilirubin and related albumin-bound toxins. Systems like the double plasma molecular adsorption system (DPMAS) may also remove inflammatory mediators, antibodies, and other medium-weight toxins. These interventions serve as supportive therapies for critically ill patients, acting when native liver function is profoundly impaired, but the underlying adsorption kinetics and impact on overall outcome are still under investigation

Other names

Extracorporeal bilirubin adsorptionBilirubin hemoadsorptionPlasma adsorption perfusionDouble plasma molecular adsorption system (DPMAS)Hemoperfusion for bilirubin removal

Physical adsorption of bilirubin (both conjugated and unconjugated) onto synthetic polymeric cartridges, typically via hydrogen bonding, hydrophobic, and electrostatic interactions; clearance of albumin-bound toxins that dialysis cannot remove