Experience with Sephadex gel filtration in assessing the risk of bilirubin encephalopathy in neonatal jaundice.

Clinical experience with Sephadex gel filtration for evaluation of the bilirubin binding affinity of serum in neonatal jaundice is reported. In serum specimens from 362 jaundiced neonates the results of the test were in most cases in good agreement with the independently determined decision to perform exchange transfusion. In all relevant cases of the 24 with bilirubin encephalopathy the Sephadex test was strongly positive. The test was positive at lower bilirubin levels and bilirubin:albumin molar ratios in preterm as compared with term neonates, especially those in poor clinical conditions. Among term infants the test indicated an increase in bilirubin binding affinity after the fifth day of life. The Sephadex test appears to be of practical value in supplementing and refining existing criteria for exchange transfusion.