The effect of intraportal administration of prostaglandin E1 on liver blood flow and liver function

BACKGROUND/AIMS: Prostaglandin El (PGE1) exerts a hepatic cytoprotective ac tion directly and indirectly through enhancing hepatic blood flow. Although PGE1 is usually administered systemically, more than 60% of PGE1 is inacti vated during only a single passage through the lung. By administering PGE1 intraportally the intrahepatic level of this drug can be increased effectiv ely and liver dysfunction might be prevented. In this study, the effect of intraportal administration of PGE1 to patients who underwent hepatectomy wa s estimated. METHODOLOGY: 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 c ontrol group (n=12). Laboratory data and hepatic portal blood flow were exa mined before and after hepatectomy. In the PGE1 group, PGE1 was continuousl y infused at a dose of 120 mu g/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 grou ps. Elevation of total bilirubin was more significantly suppressed in the P G 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 administrati on of small doses of PGE1 is effective for the protection of hepatic functi on after hepatectomy.