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[Liver function in newborn infants with conjugation hyperbilirubinemia after exchange transfusion and hemosorption]
Insights
Neonatal jaundice treatments impact liver function. Substitution transfusion impairs liver function and albumin
Area of Science:
- Neonatal Medicine
- Hepatology
- Biochemistry
Background:
- Neonatal conjugated jaundice is a critical condition requiring effective treatment.
- Understanding the biochemical changes associated with jaundice treatments is vital for improving patient outcomes.
Purpose of the Study:
- To investigate the effects of substitution transfusion and hemoperfusion on liver function markers in neonates with conjugated jaundice.
- To compare the impact of these two treatments on bilirubin metabolism and protein synthesis.
Main Methods:
- Analysis of bilirubin, cholesterol, total protein, cholyl glycine, cholinesterase, and alanine aminotransferase levels.
- Monitoring biochemical parameters at 1 and 5 days post-treatment in 40 neonates.
- Comparison of pre- and post-surgical treatment (substitution transfusion and hemoperfusion) values.
Main Results:
- Substitution transfusion was found to inhibit protein synthesis in the liver and increase cholyl glycine levels, potentially reducing albumin's bilirubin-binding capacity.
- Extracorporeal detoxification (hemoperfusion) normalized protein synthesis, decreased cholyl glycine, and enhanced albumin's bilirubin-binding capacity.
- Treatment effects were observed over 1 and 5 days, indicating dynamic changes in liver function.
Conclusions:
- Substitution transfusion may have detrimental effects on liver function and albumin's capacity to bind bilirubin.
- Hemoperfusion appears to be a more beneficial treatment for neonatal conjugated jaundice, restoring liver function and improving bilirubin clearance.
- Further research is warranted to optimize treatment strategies for neonatal conjugated jaundice.
Abstract:
Overall 40 neonates with conjugation jaundice were examined. A study was made over time (after 1 and 5 days) of the content of bilirubin, cholesterol, total protein, cholyl glycine, cholinesterase, and alanine aminotransferase before and after surgical treatment (substitution transfusion and hemoperfusion). It has been established that substitution transfusion inhibits protein synthesizing liver function and raises the content of cholyl glycine. In the authors, opinion, this reduces the bilirubin-binding capacity of albumin and increases hepatocyte membrane permeability. Extracorporeal detoxication makes protein synthesizing liver function return to normal, minimizes the content of cholyl glycine, promoting the growth of the bilirubin-binding capacity of albumin.