The effect of cisapride on total parenteral nutrition-associated cholestasis in rats

Background: Cholestasis is a frequent problem in patients on total parenter al nutrition. Cisapride has a prokinetic effect on the biliary system, but its effect on hepatic excretory function is unknown. Objectives: To study the effect of cisapride on TPN-induced cholestasis in a rat model. Methods: Bile flow and bile salt secretion rate were measured in rats given TPN. There were four groups of 8 to 13 animals each. After a one hour base line period during which all four groups received i.v. saline infusion, two groups received a TPN solution for another 2 hours, while saline was infus ed in the two control groups. At the beginning of the second hour, 2 mg/kg cisapride was injected i.v. as a bolus into one experimental and one contro l group. Bile was collected from the common bile duct. Results: At the end of the third hour, TPN caused a significant reduction i n bile flow (P<0.02) and bile salt secretion rate (P<0.001) (61.24 vs. 50.7 4 mu l/min/kg, and 1.173 vs. 0.799 mu mol/min/kg, respectively). Addition o f cisapride abolished the cholestatic effect of TPN. Conclusions: Cisapride has a protective effect against TPN-associated chole stasis. This may have clinical significance, and further studies are warran ted.