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17.01.2022 | Case Report

Single-pass albumin dialysis and hemoadsorption for bilirubin and bile acids removal for a child with hyperbilirubinemia after ventricular assist device implantation

verfasst von: Wun Fung Hui, Kin Shing Lun, Kam Lun Hon

Erschienen in: Journal of Artificial Organs | Ausgabe 3/2022

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Abstract

We report the successful management of hyperbilirubinemia using two different modalities of extracorporeal bilirubin removal therapy for a pediatric patient. A 13-year-old boy with dilated cardiomyopathy requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) developed acute kidney injury and was dependent on continuous renal replacement therapy. He developed hyperbilirubinemia with a peak total bilirubin level of 786 μmol/L after implantation of biventricular assist device (BiVAD). Extracorporeal bilirubin and bile acids removal using single-pass albumin dialysis (SPAD) with 4% albumin as dialysate brought down the bilirubin level to 672 μmol/L after 21 h of therapy. Subsequently, he was started on two sessions of hemoadsorption using the Cytosorb® column which further lowered the total bilirubin level to 306 μmol/ in 24 h and 173 μmol/ after the treatment. No complication was encountered. Our case illustrated that both SPAD and hemoadsorption can effectively and safely reduce the serum bilirubin and bile acid levels in pediatric patients with BiVAD implantation. The ease of set-up, faster rate of bilirubin decline and capability of cytokine removal make hemoadsorption a favorable alternative to albumin dialysis.
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Metadaten
Titel
Single-pass albumin dialysis and hemoadsorption for bilirubin and bile acids removal for a child with hyperbilirubinemia after ventricular assist device implantation
verfasst von
Wun Fung Hui
Kin Shing Lun
Kam Lun Hon
Publikationsdatum
17.01.2022
Verlag
Springer Nature Singapore
Erschienen in
Journal of Artificial Organs / Ausgabe 3/2022
Print ISSN: 1434-7229
Elektronische ISSN: 1619-0904
DOI
https://doi.org/10.1007/s10047-022-01309-4

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