title: A possible increase in plasma norepinephrine by removal of the liver.
abstract: BACKGROUND
  It has recently been suggested that the human liver plays an important role in clearing plasma norepinephrine, especially in restricting most of the norepinephrine to reach the systemic circulation from the gut.
  
  
  METHODS
  We examined the changes in plasma catecholamine levels in a patient undergoing extracorporeal hepatic resection and 4 patients undergoing living-related orthotopic liver transplantation.
  
  
  RESULTS
  While the changes in plasma epinephrine levels were not necessarily consistent with the proposal that plasma catecholamine levels increase during the anhepatic period, plasma norepinephrine did show a transient increase in accordance with the anhepatic period in all cases. Although we could not rule out the increase in the inflow rate of norepinephrine into plasma, the interrupted hepatic elimination of norepinephrine, especially released from the gut, seemed to be partly responsible for the anhepatic period-associated increase in plasma norepinephrine.
  
  
  CONCLUSIONS
  The present finding might have the potential to improve perioperative management of patients undergoing extracorporeal hepatic resection and orthotopic liver transplantation.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Irita
authors.forename: H
authors.initials: H
authors.lastname: Okamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000322:Adrenergic Agonists / Q000097:blood; D000316:Adrenergic alpha-Agonists / Q000097:blood*; D000328:Adult; D002648:Child; D004837:Epinephrine / Q000097:blood; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006501:Hepatic Encephalopathy / Q000601:surgery; D006801:Humans; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000322:Adrenergic Agonists; D000316:Adrenergic alpha-Agonists; D009638:Norepinephrine; D004837:Epinephrine