Bilirubin Turnover Studies in Normal and Pathologic States Using Bilirubin-^14C

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Abstract
Bilirubin-Cl4 in tracer quantities was administered to 26 patients in 29 studies to determine the plasma bilirubin-C14 specific activity disappearance rates. Unconjugated bilirubin was separated from the conjugated pigments by a solvent method. The plasma disappearance curve was found to take the form of the sum of 2 exponentials, the more rapid of which had an average Tl/2 of 21.5 min. A multi-compartment model of bilirubin metabolism is proposed on the basis of the data, and calculations of bilirubin production and inter-compartmental rate constants were made. A mechanism is postulated to explain the hyper-bilirubinemia of Gilbert''s disease. Eight patients were studied with a nonradioactive bilirubin infusion test, and the results were compared with the isotope studies. It was concluded that the blllrubln-Cl4 method provided a more accurate evaluation of bilirubin production and of hepatic excretion patterns.
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