The effect of intraportal administration of prostaglandin E1 on liver blood flow and liver function.
OBJECTIVE
Prostaglandin E1 (PGE1) exerts a hepatic cytoprotective action directly and indirectly through enhancing hepatic blood flow. Although PGE1 is usually administered systemically, more than 60% of PGE1 is inactivated during only a single passage through the lung. By administering PGE1 intraportally the intrahepatic level of this drug can be increased effectively and liver dysfunction might be prevented. In this study, the effect of intraportal administration of PGE1 to patients who underwent hepatectomy was estimated.


METHODS
Twenty patients who underwent hepatectomy from January 1995 to December 1996 were divided into 2 groups, i.e., a PGE1 group (n=8) and a control group (n=12). Laboratory data and hepatic portal blood flow were examined before and after hepatectomy. In the PGE 1 group, PGE 1 was continuously infused at a dose of 120 microg/day for 5 days through a catheter inserted into the portal vein via the gastroepiploic vein.


RESULTS
There was no difference in the post-operative change in aspartate aminotransferase (AST) or alanine aminotransferase (ALT) between the 2 groups. Elevation of total bilirubin was more significantly suppressed in the PG group than in the control group. Total branched-chain amino acids and the tyrosine ratio reached their peak on the 5th post-operative day (POD) and were significantly higher in the PG group. Post-operative portal blood flow was significantly increased in the PG group.


CONCLUSIONS
Our results indicated that continuous intraportal administration of small doses of PGE1 is effective for the protection of hepatic function after hepatectomy.
Inagaki
H
H
Department of Surgery II, Nagoya University School of Medicine, Japan.
Kurokawa
T
T
Nonami
T
T
Miwa
T
T
Nakao
A
A
Takagi
H
H
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage*; D001783:Blood Flow Velocity / Q000187:drug effects; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007262:Infusions, Intravenous; D008099:Liver / Q000098:blood supply*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000187:drug effects; D011169:Portal Vein; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil