Preliminary Evaluation of Six Current Bilirubin Adsorbents on Potential Application for the Hemoperfusion of Severe Neonatal Jaundice

Background: Now hemoperfusion has not been used for the treatment of severe neonatal jaundice, and bilirubin adsorbent with high adsorption and safety should be the prerequisite for the use. Objectives: To investigate the adsorption of six kinds of current adult/industrial bilirubin adsorbents from severe neonatal jaundice plasma, then screen the best one with highest adsorption for further evaluations, with an aim to provide preliminary experimental reference for the potential clinical use of hemoperfusion in newborn. Methods: Six kinds of current bilirubin adsorbents [NKA-9, NK-110, polymethacrylic acid (PMMA), polyvinyl alcohol (PVA), chitosan and burning resin] were selected for the investigation. Under the proportion of 1 portion of adsorbent (g) to 2 portion of severe neonatal jaundice plasma (ml), the adsorbent was allowed to dynamically contact the plasma (recycled from the discarded plasma of severe neonatal jaundice inpatients after exchange transfusion treatment) at 37 °C for 1 h respectively, then their adsorption for bilirubin was calculated and compared, and then based on the comparative result, the adsorbent with best adsorption was subject to further evaluation such as its effect on the blood elements, the hemolysis system and blood clotting system of newborn. Results: Under the same test conditions, the adsorption of NKA-9 for bilirubin was the best and up to 85 %, and its effect on other physiological indexes was clinically acceptable. Conclusion: The preliminary evaluations offer us the knowledge and reference of hemoperfusion therapy being potentially applied in the treatment of severe neonatal jaundice, as well as other shortcomings existing within the therapy to be overcome.