Beneficial effects of prostaglandin E₁ on hemodynamic changes during liver transplantation in pigs

Abstract

The vasodilative action of prostaglandin E_l (PGE₁) on the systemic and pulmonary circulation was investigated in swine models of orthotopic liver transplantation. In the PGE₁-treated group (n = 8), PGE₁ (0.05 μg/kg per minute) was intravenously infused from the onset of the anhepatic stage to 30 min after revascularization. During the anhepatic stage, PGE₁ decreased systemic vascular resistance without a corresponding hypotension, so cardiac output was maintained at a higher level. In the control group (n = 8), pulmonary vascular resistance increased to 3 times the anhepatic value during reperfusion, accompanied by a decline in cardiac output with a 28% decrease in blood pressure. In the PGE₁-treated group, on the other hand, pulmonary vascular resistance was maintained within the normal range without any associated decrease in cardiac output. The blood pressure decreased slightly by 12%. In conclusion, in this model, PGE₁, increased cardiac output without hypotension during the anhepatic stage and also prevented postreperfusion pulmonary hypertension and the subsequent systemic hypotension.