Combined evaluation of total and functional liver plasma flows and intrahepatic shunting

Gianpaolo Molino, Paolo Avagnina, Marco Ballarè, Mauro Torchio, Anna Grazia Niro, Patrizia Egidia Aurucci, Maurizio Grosso, Cesare Fava

Research output: Contribution to journalArticlepeer-review

Abstract

A diagnostic protocol was studied, designed to evaluate the main parameters of liver circulation in man. A water solution of d-sorbitol (S) and indocyanine green (ICG) was infused intravenously in six controls and nine cirrhotics. Steady-state renal and hepatic S clearances as well as hepatic ICG clearance were calculated. In controls the values (mean ±sd) of the independent measurements of S and ICG hepatic clearance were 978±107 and 519±142 ml/min, respectively, while in cirrhotic patients they were 554±238 and 231±90 ml/min. Owing to the kinetic properties of S, its hepatic clearance may be regarded as a measure of functional liver plasma flow (FLPF). The total liver plasma flow (TLPF) values (mean±sd), calculated according to Fick's principle, were 1091±157 ml/min (S method) and 1033±153 ml/min (ICG method) in controls, and 1251±554 and 1284±677 ml/min in cirrhotics. In controls, FLPF was found to be very close to TLPF. In cirrhotic patients the difference between TLPF and FLPF (ranging from 169 to 2093 ml/min when measured by S method) was considered as an approximate estimate of intrahepatic shunting. The procedure is safe and simple and may add a new dimension to the investigation of hepatic circulation.

Original languageEnglish
Pages (from-to)1189-1196
Number of pages8
JournalDigestive Diseases and Sciences
Volume36
Issue number9
DOIs
Publication statusPublished - Sep 1991

Keywords

  • clearance methods
  • d-sorbitol
  • intrahepatic shunting
  • liver cirrhosis
  • liver plasma flow

ASJC Scopus subject areas

  • Gastroenterology

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