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

BACKGROUND/AIMS: Prostaglandin E1 (PGE1) exerts a hepatic cytoprotective action directly and indirectly through enhancing hepatic blood flow. Although PGE1 is usually administered systemically, more than 60% of PGE1 is inactivated during only a single passage through the lung. By administering PGE1 intraportally the intrahepatic level of this drug can be increased effectively and liver dysfunction might be prevented. In this study, the effect of intraportal administration of PGE1 to patients who underwent hepatectomy was 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 control group (n=12). Laboratory data and hepatic portal blood flow were examined before and after hepatectomy. In the PGE 1 group, PGE 1 was continuously infused at a dose of 120 microg/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 groups. Elevation of total bilirubin was more significantly suppressed in the PG 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 administration of small doses of PGE1 is effective for the protection of hepatic function after hepatectomy.