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The amounts of mRNA in placenta that encode both the HO-1 and HO-2 isoforms have been measured, showing an elevated expression of HO-2 relative to HO-1.21 Furthermore, the expression of both HO-1 and HO-2 in the placenta increased with gestational age.21 Transport and Excretion of Bilirubin in the Fetus and Newborn Unconjugated bilirubin (UCB) is transported in plasma bound to albumin with a binding affinity of 107108/M at the primary binding site.22 There is also a secondary binding site with lower affinity.22,23 Because of the high affinity of albumin for bilirubin, equilibrium concentrations of free (unbound) bilirubin in plasma are only in the low nanomolar range, even in significant hyperbilirubinemia.24,25 However, when the molar concentration of bilirubin exceeds that of albumin, free bilirubin concentrations may increase significantly.22,24,26 Binding of bilirubin to albumin increases with postnatal age but is reduced in sick infants and in the presence of exogenous or endogenous binding competitors.2730 In addition to albumin, bilirubin can also bind to other proteins (e.g., -fetoprotein and ligandin), as well as to lipoproteins and to erythrocytes.3134 When the bilirubinalbumin complex comes in contact with hepatocytes, bilirubin is transported into the cell