The major abnormal plasma lipoprotein of cholestasis (LP-X) was isolated from bFood plasma and from perfusates of isolated livers of rats with biliary obstruction. In both cases LP-X was composed mainly of about equimolar parts of phospholipids and unesterified cholesterol; the small protein component was primarily the arginine-rich apolipoprotein. By electron microscopy, LP-X appeared as a unilamellar liposome (690 A mean diameter, range 400-1000 A) with the trilaminar staining image typical of phospholipid bilayers.Extensive block staining of cholestatic livers for 48 hr with warmed uranyl acetate (370) permitted the visualization of vesicles indistinguishable from LP-X within hepatic parenchyma. These trilaminar-staining vesicles occurred predominantly within bile canaliculi. They also were seen in nearby cytoplasmic vacuoles or invaginations between hepatocytes and in the space of Disse. Similar vesicles were not seen in the endoplasmic reticulum or Golgi cisternae. These observations raise the possibility that the vesicles are formed within bile canaliculi and are transported from the canaliculi to the space of Disse within pinocytotic vacuoles. Cholestasis may be defined as the interruption of bile flow from the biliary passages of the liver with consequent appearance of biliary constituents in blood plasma. In humans, prolonged obstruction to bile flow causes a progressive and often equimolar rise in plasma unesterified cholesterol and phospholipid (1-4). This unique hyperlipidemia results largely from the accumulation in plasma of a major abnormal lipoprotein that is separated with normal low density lipoproteins (LDL) by ultracentrifugation. This abnormal lipoprotein, which differs greatly in lipid and protein composition from normal LDL, is commonly called LP-X (3,5). Most normal plasma lipoproteins are pseudomicellar (6) with a core of relatively nonpolar triglycerides and cholesteryl esters covered by a monomolecular surface of phospholipids, unesterified cholesterol, and apoproteins, whereas LP-X is largely a unilamellar liposome of about 400-700 A diameter (4, 7-9). It probably exists in vivo as a bilayer vesicle of equimolar phospholipids and unesterified cholesterol containing small amounts of plasma proteins (mainly albumin) in its internal aqueous compartment together with some apolipoproteins adsorbed on its surface (4,6,8,9). Several other abnormal plasma lipoproteins have also been reported in patients with cholestasis (8, 10-13).The origin of LP-X is unknown, although it is generally assumed to be produced by regurgitation of bile components into the blood (for review, see ref. 14). Recent studies have shown that LP-X occurs in the plasma of animals after surgical interruption of the common bile duct (15)(16)(17)(18) (19)(20)(21). The perfusion medium, which was pumped at a rate of 1 ml min-1 g-1 of liver, was composed of three parts of Krebs-Ringer bicarbonate buffer, pH 7.4, containing 1.5 mg of glucose per ml and 1 part of thrice-washed rat erythrocytes. The bile duct was cannul...