PHARMACOKINETICS OF DEXTRAN-70 IN PATIENTS WITH CIRRHOSIS AND ASCITESUNDERGOING THERAPEUTIC PARACENTESIS

Background/Aim: Dextran-70 is frequently used as a plasma expander in patients with cirrhosis treated with large-volume paracentesis to prev ent post-paracentesis hypovolemia, which is thought to develop after 2 4 h following the procedure, However, there are no studies on Dextran- 70 pharmacokinetics in cirrhosis, Methods: Nine patients with alcoholi c cirrhosis and tense ascites treated with a 5-1 paracentesis were giv en 500 mi of Dextran-70, Blood samples to measure the plasma concentra tion of dextran were obtained 15 and 30 min, 1, 2, 3, 6, 12 and 24 h a nd 2 and 6 days after the end of the infusion, Nine healthy volunteers were studied in identical fashion after infusion of 100 mi of Dextran -70. The plasma concentration of dextran was determined by the anthron e method, A bicompartmental model was used to analyze the pharmacokine tic parameters, Results: There were no significant differences between patients with cirrhosis and controls in the volume of distribution (7 .7 +/- 0.6 vs 7.3 +/- 1.2 1), half-life of the first and second compon ent of plasma disappearance (2.96 +/- 0.69 and 80.3 5.9 h in patients with cirrhosis vs 2.82 +/- 0.69 and 67.1 +/- 10.7 h in controls), Conc lusions: The pharmacokinetics of Dextran-70 in patients with cirrhosis and ascites after large-volume paracentesis is similar to that in con trols, This may explain why Dextran-70 is less effective than albumin in preventing paracentesis-induced hypovolemia, which starts after mos t Dextran fraction has disappeared from plasma.