Clinical evaluation of Sephadex gel filtration in estimation of bilirubin binding in serum in neonatal jaundice

Clinical experience with a Sephadex gel filtration test-kit for the evaluation of bilirubin binding affinity of serum in neonatal jaundice is reported. In serial serum specimens from 166 jaundiced neonates the results of the test in most cases were in accord with the independent clinical decision to perform exchange transfusion. In all 9 cases with clinical kernicterus the Sephadex test was strongly positive (very low bilirubin binding affinity of serum). The test was positive at lower bilirubin levels and bilirubin/albumin molar ratios in preterm as compared with term neonates, especially in those in poor clinical condition. Among term infants the test indicated an increase in bilirubin binding affinity after the 5th day of life.