Prostaglandin E1 increases survival with extended anhepatic phase during liver transplantation.
OBJECTIVE
The authors investigated the intraoperative treatment effects of Prostaglandin E1 (PGE1) for extension of the anhepatic phase and improvement of survival in a rat liver transplant model.


BACKGROUND
Cross-clamping the inferior vena cava and the portal vein during liver transplantation causes severe pathophysiologic changes during surgery. The time of the anhepatic phase is strictly limited and results in a very tenuous period during the liver transplant operation.


METHODS
Prostaglandin E1 was infused at 0.5 microgram/kg/min into five subgroups of rats with 20, 30, 40, 60, and 80 minutes of anhepatic phase during transplantation. Bile secretion, serum aspartate transaminase (AST), lactic dehydrogenase (LDH), and blood gas analysis were studied in the 30-minute subgroup. The results were compared with the sham-operated and control groups.


RESULTS
Intraoperative treatment with PGE1 extended the maximal anhepatic phase from 30 minutes in the sham-operated group up to 80 minutes, and increased survival. Significant changes in the PGE1 treated rats in the 30-minute subgroup included an increase of bile flow and bile salt output and decrease of AST and LDH activities after surgery. Blood gas analysis showed a decrease in acidosis and hypercarbia at the end of the anhepatic phase.


CONCLUSIONS
The PGE1 treatment increased survival with extended anhepatic phase during rat liver transplantation. The beneficial effects can be attributed to its biologic activities.
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville.
H S
HS
Xu
L K
LK
Rosenlof
T L
TL
Pruett
R S
RS
Jones
D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood / Q000187:drug effects; D001647:Bile Acids and Salts / Q000032:analysis; D001784:Blood Gas Analysis; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D007770:L-Lactate Dehydrogenase / Q000097:blood / Q000187:drug effects; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008954:Models, Biological; D051381:Rats; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow / Q000187:drug effects; D015996:Survival Rate; D013997:Time Factors
D001647:Bile Acids and Salts; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000527:Alprostadil