Continuous infusion of prostaglandin E-1 via the superior mesenteric artery can prevent hepatic injury in hepatic artery interruption through passiveportal oxygenation

Aims/Background: Hepatic artery interruption (HAI) causes severe ischemic l iver damage, especially following hepatopancreatobiliary surgery. In order to inhibit a decrease in oxygen delivery after HAI, continuous infusion of PGE(1) via the superior mesenteric artery (SMA) was administered in pigs an d changes in hepatic blood flow and oxygen delivery were investigated. Furt hermore, its effectiveness in the prevention of liver injury was evaluated by histology and serum enzyme levels. Methods. Animals were subjected to HA I without PGE(1) infusion (control group n= 6) and to continuous infusion o f PGE(1) (0.02 mu g/kg/min) into the SMA (PGE(1) group n=6). Results ann Co nclusion: PGE(1) infusion via the SMA not only increased the portal blood h ow but also elevated the oxygen content of the portal blood. The reduction in oxygen delivery to the liver was 50% in the control group, and only 13% in the PGE(1) group. Serum aspartate aminotransferase (AST) and lactate deh ydrogenase (LDH) levels 24 h after HAI in the control group were 3415+/-128 3 IU/L and 9839+/-2959 respectively while in the PGE(1) group they were 939 +/-426 IU/L and 5510+/-1545 IU/L respectively. Histological examination sho wed massive necrosis in the control group at 72 h but only focal liver cell necrosis in the PGE(1) group. Based on this finding and the fact that this treatment can be performed easily and safely, continuous infusion of PGE(1 ) via the SMA may be a useful intervention to prevent severe liver damage a fter hepatic artery interruption.