Measurement and Clinical Usefulness of Delta Bilirubin in Liver Disease

Delta bilirubin is albumin bound conjugated bilirubin that can be calculated by formula [Total bilirubin - (conjugated + unconjugated bilirubin)]. Newer technology like dry chemistry provide conjugated and unconjugated bilirubin fraction which is more specific and informative than direct and indirect bilirubin by conventional method in which only approximate values of conjugated bilirubin can be measured. In cholestasis conjugated bilirubin combines with albumin non enzymatically and form delta bilirubin in circulation and remains for long duration. The present review describes the usefulness of delta bilirubin in cholestasis, chronicity of liver diseases, in pediatric jaundice, transplant rejection and other jaundice condition.clinical correlation of delta bilirubin in all conditions have been summarized and their future perspectives are discussed.