Plasma exchange for hyperbilirubinemia following implantation of a left ventricle assist system: a case report.

摘要: A 49-year-old patient with end-stage dilated cardiomyopathy underwent implantation of a left ventricular assist system (LVAS). Although the systemic circulation seemed to be improved, serum total bilirubin (Tbili) level increased sharply in early postoperative period (preoperative Tbili, 5.7 mg/dl; day 3, 33.6 mg/dl). Plasma exchange (PE) was performed 7 times from 4, and Tbili decreased 16.3 mg/dl by 11. Thereafter, normalized concomitant improved circulatory condition. The cause hyperbilirubinemia considered temporary right dysfunction or hepatic sinusoid endothelial dysfunction. liver function recoverable, so PE had been effective this case. Unfortunately, suffered midbrain infarction ultimately died. From experience, is recommended if it judged that can preserved adequate, but its implementation should not delayed. It essential LVAS implanted before damage occurs end-organ thus prevent hyperbilirubinemia.