Effect of dopamine infusion (3-30 mu g/kg/min) on hepatic hemodynamics

Background. While dopamine produces well-characterized dose-dependent effec ts on systemic hemodynamics, there is a paucity of information regarding it s effects on hepatic hemodynamics, Infusion rates above 10 mu g/kg/min are reported to produce significant vasoconstriction and impair organ perfusion . Therefore, donors are sometimes considered unsuitable when higher doses o f dopamine are in use. The aim of this study was to determine the effect of increasing doses of dopamine on hepatic hemodynamics in a nonanesthetized swine model. Materials and methods. Sixteen pigs were instrumented with indwelling cathe ters in a peripheral artery, peripheral vein, portal vein, and hepatic vein and flow probes around the portal vein and hepatic artery. After recovery, the following variables were measured 10 +/- 1 days postinstrumentation: h epatic arterial flow (HAF), portal venous flow (PVF), mean systemic arteria l pressure (MAP), central venous pressure (CVP), portal venous pressure (PV P), hepatic venous pressure (HVP), heart rate (HR). Recordings were obtaine d at baseline and subsequently when dopamine was infused at rates of 3, 6, 12, 15, 21, and 30 mu g/kg/min increasing at l-h intervals. Results. HAF and PVF increased linearly over the entire infusion range, to 69 and 13% over baseline, respectively (P < 0.001, P < 0.05). Total hepatic blood flow rose 23% over baseline at the 30 mu g/kg/min dosage (P < 0.01). MAP increased linearly 13% over the range 12 to 30 mu g/kg/min (P < 0.001) . CVP, HVP, and PVP did not change significantly. HR decreased from 12 to 1 5 mu g/kg/min (P < 0.01), then increased from 15 to 30 mu g/kg/min (P < 0.0 5). Conclusion. These data show that dopamine infused at dosages of 3-30 mu g/k g/min augments HAF, PVF, and THBF and that this effect is linear. These res ults suggest high-dose dopamine infusion does not disqualify a potential do nor liver for transplantation. (C) 2000 Academic Press.