HEPATIC HYPOPERFUSION AFTER INTESTINAL REPERFUSION

Background. Intestinal ischemia-reperfusion injury (IIR) induces hepat ic and pulmonary dysfunction and thus has been used a a model of multi ple organ failure syndrome. This study examines the hypothesis that he patic blood flow is markedly reduced in this injury model. Methods. Sp rague-Dawley rats underwent 120 minutes of intestinal ischemia and 60 minutes of reperfusion (IIR). Hepatic blood flow was measured with rad iolabeled microspheres and Doppler flow probes. Hepatic dysfunction wa s quantitated by measuring bile flow and serum alanine aminotransferas e and hepatic tissue adenosine triphosphate levels. Sham-operated anim als served as controls. Results. Intestinal ischemia reduced portal fl ow by 66% when compared with sham-operated animals (p = 0.0001) but ha d no effect on hepatic arterial flow. In contrast, reperfusion reduced hepatic artery flow by 80% when compared with controls (p = 0.002) wi th most of this change occurring within 5 minutes of reperfusion. IIR induced a 63% reduction in bile flow (p < 0.05), a fivefold rise in se rum alanine aminotransferase level (p < 0.0002), and a 33% reduction i n hepatic adenosine triphosphate level (p < 0.05). Conclusions. These data suggest that IIR induces profound hepatic hypoperfusion, which is temporally related to acute hepatic dysfunction. This observation sug gests that hepatic ischemia may contribute to IIR-induced liver injury .