Test Name: BILIRUBIN PANEL
EPIC Search Term: LABBILIP
Synonyms: TOTAL CONJUGATED DIRECT BILT BILC BC BILIP
Panel Composition: Bilirubin Total
Bilirubin Conjugated (Direct)
Preferred Container: 1 x 0.6 mL Green Lithium Heparin with Gel Microtainer
Alternate Container: 1 x 0.6 mL Amber Microtainer with Gel
1 x 1 mL Green Lithium Heparin Tube with Gel
1 x 1 mL Red/Black Serum Separator (SST) Vacutainer
Specimen Transport: TRANSPORT IMMEDIATELY.
**SPECIMEN MUST BE RECEIVED IN LAB WITHIN 2 HOURS AFTER COLLECTION if maintained at room temperature.**


Keep cold and protect from light if transport is delayed.
Causes for Rejection: Grossly hemolyzed sample
Interfering Substances: Hemolysis and exposure to light will artefactually decrease the total and conjugated bilirubin results
Testing Frequency: Daily
Expected Turn Around Time: Same day
Clinical Application: Total bilirubin (Bt) as measured by the diazo method (J-G assay) includes all forms of bilirubin; unconjugated bilirubin (Bu), mono- and di-glucuronide conjugated bilirubin (Bc), and delta-bilirubin (covalently bound to albumin.

Following total bilirubin in the post-natal period: Use total bilirubin (Bt) and the
Bhutani Normogram to follow infants in the immedate post-natal period who may be at risk for hyperbilirubinemia.

Candidates for Liver Transplantation: Total bilirubin (Bt) should be used instead of measuring Bu and Bc when assessing and qualifying candidates for liver transplantation. The sum of Bu and Bc will typically be less than Bt due to the fact the spectrophotmetric method does not measure delta-bilirubin.

Conjugated bilirubin (Bc) is used for evaluating liver and biliary diseases. An increased direct bilirubin occurs in both intrahepatic and extrahepatic biliary tract obstruction. Elevation of bilirubin in hepatocellular disease is seen in hepatitis, cirrhosis, and advanced neoplastic states. Conjugated bilirubin is also increased in Dubin-Johnson and Rotor syndrome.

Conjugated bilirubins is measured at TCH using a two-wavelength spectrophotometric assay that is not interfered with by hemoglobin.

Please see hyperlink for the Test Info sheet:
Bilirubin Test Info
Reference Ranges: Total Bilirubin
Premature
0-24 Hrs = 1-8 mg/dl
24-48 Hrs = 6-12 mg/dl
3-5 Days = 10-14 mg/dl
Full-Term
0-24 Hrs = 2-6 mg/dl
24-48 Hrs = 6-10 mg/dl
3-5 Days = 4-8 mg/dl
6 Days-1 Mo = No normals available

Conjugated Bilirubin (Direct)
>1 Month - Adult = <0.35 mg/dl
Unit of Measure: mg/dL
Test Performed By: Texas Children's Hospital Pathology Services

Available at TCH Main Campus: 832-824-5152
6621 Fannin, MC 1-2261
Houston, TX 77030-2399

Available at TCH Pavilion for Women: 832-826-7400
6651 S. Main St.
Houston, TX 77030

Available at TCH West Campus: 832-227-1700
18200 Katy Freeway
Houston, TX 77094

Available at TCH Woodlands Campus: 936-267-5200
17600 Interstate 45 South
The Woodlands, TX 77384
Lab Section: Chemistry