TOTAL PARENTERAL-NUTRITION IMPAIRS BILE-FLOW AND ALTERS BILE COMPOSITION IN NEWBORN PIGLET

Cholestatic liver disease complicates total parenteral nutrition (TPN) in premature neonates, We investigated TPN-induced liver disease in t he newborn piglet. hypothesizing that: (1) TPN impairs bile flow by re ducing the bile acid-dependent (BADF) and the bile acid-independent co mponent of bile flow (BAIF); and (2) TPN changes bile composition. For three weeks, eight piglets received TPN and nine piglets were fed mil k, Basal bile flow was measured and bile composition analyzed for bile acids, cholesterol (C), phospholipids (PL), and PL fatty acids, Bile flow was also measured after stimulation with 20, 50, and 100 mu mol/k g taurocholic acid (TCA). Liver histology and bilirubin content were e xamined. Basal bile flow was reduced from 11.6 +/- 1.2 mu g/l liver/10 min in orally fed animals to 1.6 +/- 0.4 mu l/g liver/10 min in the T PN group. The stimulated bile Bow in the TPN group did not respond to TCA and was lower than in the orally fed animals at each TCA dose. Bot h BADF and BAIF were significantly lower in the TPN group, Bile acid s ecretion was less than 50% of control values and total C and PL secret ions were less than 5% of control. Liver and serum bilirubin were elev ated in the TPN group. The newborn piglet is a valid model to study TP N-induced cholestasis, characterized by decreased bile acid secretion, impaired BADF and BAIF, and reduced bile flow stimulation after intra venous TCA.