Novel Method to Remove Bilirubin from the Blood of Jaundiced Rats: A Preliminary Study

BACKGROUND The removal of bilirubin from serum is the primary method for treating hyperbilirubinemia. However, currently used treatment methods have several limitations.AIMTo introduce a novel method to remove bilirubin from the blood of jaundiced rats.METHODS This novel therapy involved cross-circulation of blood between a rat liver preserved in vitro and a rat with hyperbilirubinemia. The liver was perfused with blood from the model animal, resulting in the clearance of serum bilirubin. Twenty rats with jaundice caused by acute liver failure induced using D-galactosamine were treated. All model animals were randomly divided into two groups based on whether they received the novel therapy. Serum samples were collected before modelling, at the beginning of treatment, and 2 hours after treatment. The levels of serum transaminase and bilirubin were detected and compared between different time points. Histological examination of the liver in vitro was also performed after the treatment. Long-term survival was compared by Kaplan-Meier analysis between rats who did and did not receive the novel treatment.RESULTSIn vitro, the liver could be perfused with the blood from the model animal through the portal vein. The bile produced by the liver after 1 hour of therapy was darker than the bile produced while harvesting. Across different hyperbilirubinemia models, serum total bilirubin level was significantly improved (24.8 ± 1.2 vs. 17.4 ± 1.2 μmol/L, P<0.05), despite a rise serum transaminase levels after treatment (AST: 4612 ± 382 vs. 5144 ± 390 U/L, P＞0.05; ALT: 5051 ± 722 vs. 5488 ± 707 U/L, P＜0.05). No necrosis was found in the preserved liver tissue after treatment, and the hepatic lobule structure was normal. Hepatocyte necrosis was not found on histological examination. This novel treatment significantly raised the long-term survival rates of jaundiced rats (P <0.05).CONCLUSIONThis novel method could safely and effectively help eliminate bilirubin from the blood of jaundiced rats.