Impairment of blood rheology by cholestatic jaundice in human beings

Abstract Bilirubin and bile acids may affect erythrocytes. We investigated blood viscosity and erythrocyte structure in patients with cholestatic jaundice ex vivo and studied the short-term effects of bilirubin and bile acids in vitro. Seventeen patients with cholestatic jaundice and controls were studied. Whole-blood viscosity (adjusted hematocrit 45%) at high (94.5 sec −1 ) and low (0.1 sec −1 ) shear rate and plasma viscosity were measured. Erythrocyte structure was assessed in wet preparations of fixed cells. In vitro whole blood was incubated with increasing concentrations of bilirubin (83% conjugated) and bile acids (cholic, lithocholic, deoxycholic, and chenodeoxycholic acid) and the abovementioned investigations were performed. In patients we observed increased whole-blood viscosity at high shear rate (5.82 ± 0.69 vs 5.04± 0.27 mPa · sec, P = .0001), plasma viscosity (1.48 ± 0.22 vs. 1.23 ± 0.07 mPa · sec, P = .0004), and fibrinogen level (4.70 ± 0.98 g/L vs 2.63 ± 0.21 g/L, P P