The Measurement of Fractionated Bilirubin by Ektachem® Film Slides: Method Validation and Comparison of Conjugated Bilirubin Measurements with Direct Bilirubin in Obstructive and Hepatocellular Jaundice

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Abstract
The authors evaluated the Kodak® Ektachem® Slides for total, “direct,” conjugated, unconjugated, and albumin-bound (“delta”) bilirubin. For various concentrations of control material, the precision (CV) within- and between-day ranged from 1.7 to 2.4% (2.8–6.6%) for total bilirubin, 0.8–4.2% (1.6–11.5%) for unconjugated bilirubin, and 1.6–9.5% (2.6–20.7%) for conjugated bilirubin. The Ektachem total and “direct” bilirubin assays demonstrated excellent correlation with the Jendrassik and Grof procedure; a 30% difference was observed, however, between absoute numbers with the two direct bilirubin methods. We found the measurement of true conjugated bilirubin by the Kodak Method to be superior to the measurement of “direct” bilirubin in following the response to treatment of various hepatic disorders manifested by extrahepatic and intrahepatic biliary obstruction.