Agonal hepatic arterial vasospasm.
The effect of donor pretreatment with Dibenzyline (phenoxybenzamine) on hepatic arterial vasospasm was studied in a porcine asphyxia model. Nine pigs underwent hepatectomy without pretreatment, while six were given 2 milligrams per kilogram of Dibenzyline prior to hepatic dissection. Hepatic arterial blood flow was monitored with an electromagnetic flow probe, and after cardiac arrest, arteriograms of the hepatic circulation were obtained. Hepatic arterial vasospasm occurred in seven of the pigs in group 1 and in only one of group 2 (p less than 0.05). Agonal hepatic arterial blood flow remained constant (415 +/- 30 milliliters per minute) in pretreated pigs during asphyxia, but was markedly reduced (98.6 +/- 63.3 milliliters per minute) in nonpretreated pigs (p less than 0.05). Results of this study demonstrate the agonal occurrence of hepatic arterial vasospasm and its prevention with Dibenzyline. Donor pretreatment with alpha-adrenergic antagonists may be indicated in clinical organ procurement to prevent agonal arterial vasospasm and its potentially adverse effect on early hepatic allograft function.
Department of Surgery, University of Wisconsin School of Medicine, Madison.
A M
AM
D'Alessandro
R J
RJ
Stratta
J H
JH
Southard
M
M
Kalayoglu
F O
FO
Belzer
D000818:Animals; D001237:Asphyxia / Q000503:physiopathology; D001783:Blood Flow Velocity; D002395:Catecholamines / Q000378:metabolism; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006498:Hepatectomy; D006499:Hepatic Artery; D008102:Liver Circulation / Q000187:drug effects; D010643:Phenoxybenzamine / Q000627:therapeutic use*; D011292:Premedication; D013035:Spasm / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D013552:Swine; D014652:Vascular Diseases / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D014661:Vasoconstriction / Q000187:drug effects
D002395:Catecholamines; D010643:Phenoxybenzamine