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Hemoperfusion is a well-developed method for removing bilirubin from patients with hyperbilirubinemia. The performance of adsorbents is crucial during the process. However, most adsorbents used for bilirubin removal are not suitable for clinical applications, because they either have poor adsorption performance or limited biocompatibility. Patients with hyperbilirubinemia usually have distinctive yellow skin, indicating that collagen, a primary component of the skin, may be an effective material for absorbing bilirubin from the blood. Based on this idea, we designed and synthesized collagen (Col) and collagen-polyethyleneimine (Col-PEI) microspheres and employed them as hemoperfusion adsorbents for bilirubin removal. The microspheres have an efficient adsorption rate, higher bilirubin adsorption capacity, and competitive adsorption of bilirubin in the bilirubin/bovine serum albumin (BSA) solution. The maximum adsorption capacities of Col and Col-PEI microspheres for bilirubin are 150.2 mg/g and 258.4 mg/g, respectively, which are higher than those of most traditional polymer microspheres. Additionally, the microspheres exhibit excellent blood compatibility originating from collagen. Our study provides a new collagen-based strategy for the hemoperfusion treatment of hyperbilirubinemia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

[Display omitted] • A novel bilirubin adsorbent based on collagen and chitosan was designed and synthesized. • The adsorption capacity for bilirubin by the CS-Col microspheres increases from 24.2 to 76.9 mg/g. • The adsorption rate for albumin by the CS-Col microspheres declines from 6.9% to 2.6%. • Collagen gives the CS-Col microspheres specific bilirubin adsorption capacity. Hemoperfusion is one of the most effective treatments for the removal of bilirubin from the blood. Chitosan (CS) has been widely investigated as a hemoperfusion adsorbent to remove bilirubin due to its biocompatibility and biodegradability. However, the limited adsorption capacity of CS for free bilirubin or albumin-rich bilirubin solution, and the strong adsorption for albumin, limit its extensive use. The goal of this work is to improve specific bilirubin adsorption of CS while reducing its adsorption for albumin. In this study, collagen (Col) was chosen as a ligand and grafted onto the surface of CS microspheres to form CS-Col microspheres and therefore to improve their adsorption performance for bilirubin. The maximum adsorption capacity of the CS-Col microspheres for bilirubin increases from 24.2 to 76.9 mg/g. The enhancement factor is higher than that of other CS-based adsorbents. Moreover, the adsorption of CS-Col microspheres for albumin is effectively reduced to 2.6 %, while maintaining good blood compatibility. Compared to other CS-based bilirubin adsorbents, our CS-Col microspheres have the advantage of specific adsorbing bilirubin against albumin due to introducing collagen. This work provides new directions for designing high-performance bilirubin adsorbents. Our CS-Col microspheres show great promise for the treatment of hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

• Synthesis of ordered porous materials was summarized and discussed. • Properties of ordered porous materials was summarized and discussed. • Applications of ordered porous materials in blood purification with emphasis on hemoperfusion was summarized and discussed. Blood purification is an essential part of biomedical engineering, as well as a rapidly developing field in medicine. Hemoperfusion, which physically separates impurities from blood using adsorbents, offers an effective method for blood purification. However, traditional hemoperfusion adsorbents suffer from various limitations, such as low adsorption capacity and poor hemocompatibility. In recent years, ordered porous materials (OPMs), as a new type of material, have been emerging in the research of blood purification. OPMs exhibit several unique properties that make them ideal candidates for blood purification adsorbents, including a regularly arranged, adjustable pore structure and high specific surface area. Researchers have developed and synthesized various types of OPMs and studied their applications in hemoperfusion, demonstrating their potential to outperform conventional adsorption materials. This review covers the synthesis and properties of OPMs, as well as their applications in hemoperfusion. The authors also discuss the potential of OPMs for future clinical applications in blood purification. Based on these discussions, it appears that OPMs show an exciting avenue for further research in the field of blood purification. [ABSTRACT FROM AUTHOR]