The hepatic uptake rate for certain albuminbound drugs and metabolites correlates poorly with their equilibrium unbound concentration in the plasma, suggesting that binding equilibrium may not always exist within the hepatic sinusoids. Currently available models for the uptake process assume binding equilibrium and, thus, cannot be used to investigate this possibility. This report presents a more general model that treats plasma-bound and free concentrations separately. A solution is provided that specifies the hepatic uptake rate as a function of the total plasma concentrations of the transported substance and of binding protein and the rate constants for influx, efflux, elimination, association, dissociation, and flow. Analysis of this solution indicates that hepatic uptake may be limited by the rate of plasma flow, dissociation from the binding protein, influx into the liver, cellular elimination, or any combination of these processes. The affinity and concentration of the binding protein strongly influence which of these steps are rate-limiting in any given case, and binding equilibrium exists within the hepatic sinusoids only for binding protein concentrations greater than a specified value (the ratio of the uptake and association rate constants). The precise conditions under which each step is rate-limiting and the kinetic behavior expected when two or more steps mutually limit uptake are provided. The results are compatible with previously reported data for the uptake of certain albuminbound ligands such as bilirubin, and they offer an alternative to attributing these kinetics to the presence of an albumin receptor.The degree to which a drug or metabolite is bound to albumin in plasma is recognized as an important determinant of its rate of removal by the liver and other tissues. Indeed, it has long been assumed that only the unbound form is available for uptake (1). This assumption is not necessarily valid, however, because the bound substance always retains some free energy (2), which makes it a potential substrate for an uptake process. Recent reports have, in fact, suggested that for several albumin-bound substances (subsequently referred to as ligands), the rate of hepatic removal correlates much more closely with the bound than with the equilibriumfree concentration (3,4). To account for these and related data, it has been proposed that uptake may occur not only from the free ligand pool, but also (less efficiently) from the bound ligand pool by a mechanism involving transient binding of albumin to receptor sites on the cell surface (5, 6). According to this model, the latter pathway predominates for tightly bound ligands such as bifirubin because of their very small unbound concentrations in plasma.Although the albumin-receptor model is attractive, it is important to consider whether the traditional view that uptake depends only on the unbound ligand concentration at the liver cell surface might not also accommodate these observations. Most traditional models assume that equilibrium exists ...