Efficacy of continuous infusion of prostaglandin E1 through the superior mesenteric artery against ischemic liver cell necrosis after hepatic artery occlusion.
BACKGROUND
Hepatic artery occlusion (HAO) can cause severe ischemic liver injury, especially after an interruption of collateral circulation after extensive hepatobiliary surgery. To minimize a decrease in oxygen delivery after HAO, a continuous infusion of prostaglandin (PG)E1 through the superior mesenteric artery (SMA) was studied in comparison with other infusion routes.


METHODS
Twenty-four pigs were assigned to four groups: HAO without PGE1 (control group); HAO with PGE1 (0.02 microg/kg/min, continuously) through the jugular vein (intravenous group); HAO with PGE1 through the portal vein (PV group); and HAO with PGE1 through the SMA (SMA group). PV flow, hepatic oxygen delivery, and serum aspartate aminotransferase were measured after infusion. In addition, 72-hr survival rates were observed, and histologic examination of liver specimens was performed.


RESULTS
PGE1 infusion through the SMA seems to affect PV flow and elevate the oxygen content of portal blood, whereas other routes of administration do not. The reduction of hepatic oxygen delivery after HAO was 51% in the control group, 46% in the intravenous group, and 49% in the PV group, whereas it was limited to 13% in the SMA group. Serum aspartate aminotransferase values 24 hr after HAO were lowest in the SMA group, which was statistically significant, as confirmed by histology. The survival rate of animals was 100% in the SMA group and 33% in the other three groups.


CONCLUSIONS
These findings indicate that continuous PGE1 infusion through the SMA may prove useful in clinical settings to prevent liver damage after HAO.
Kato
Takeshi
T
Department of Surgery, Akita University School of Medicine, Akita, Japan.
Sato
Tsutomu
T
Kurokawa
Toshiaki
T
Nanjo
Hiroshi
H
Asanuma
Yoshihiro
Y
Koyama
Kenji
K
D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001157:Arterial Occlusive Diseases; D001219:Aspartate Aminotransferases / Q000097:blood; D001783:Blood Flow Velocity; D006439:Hemodynamics; D006499:Hepatic Artery; D007261:Infusions, Intra-Arterial; D007511:Ischemia / Q000473:pathology / Q000517:prevention & control*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D017538:Mesenteric Artery, Superior; D009336:Necrosis; D013552:Swine
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000527:Alprostadil