Effect of cimetidine on the hepatic extraction of indocyanine green, the portal pressure and the systemic circulation in patients with cirrhosis of the liver

1984 ◽  
Vol 62 (16) ◽  
pp. 759-764 ◽  
Author(s):  
R. Herz ◽  
M. Rössle ◽  
T. Bonzel ◽  
E. Keller ◽  
W. Gerok
Keyword(s):  
Indocyanine Green ◽  
Portal Pressure ◽  
Systemic Circulation ◽  
Cirrhosis Of The Liver ◽  
Hepatic Extraction

Indocyanine Green elimination in patients with liver disease and in normal subjects

1991 ◽  
Vol 80 (2) ◽  
pp. 155-160 ◽  
Author(s):  
E. Burns ◽  
D. R. Triger ◽  
G. T. Tucker ◽  
N. D. S. Bax
Keyword(s):  
Indocyanine Green ◽  
Healthy Subjects ◽  
Time Course ◽  
Pharmacokinetic Model ◽  
Sampling Period ◽  
Extraction Ratio ◽  
Cirrhosis Of The Liver ◽  
Hepatic Extraction ◽  
Hepatic Extraction Ratio ◽  
Using Data

1. The validity of a two-compartment pharmacokinetic model for the estimation of the hepatic extraction ratio of Indocyanine Green was tested in six patients with cirrhosis of the liver. 2. No agreement was found between the value of the hepatic extraction ratio measured directly and that calculated using the two-compartment model. 3. To investigate the reasons for the failure of the model, an extended sampling period was used to define the time course of Indocyanine Green in plasma in six healthy subjects and in six patients with cirrhosis of the liver after a bolus injection of the dye. 4. Indocyanine Green was measurable in the plasma for up to 10 h after injection in healthy subjects, and up to 48 h after injection in the patients. The plasma elimination curve in both groups was best described by a triexponential function. 5. The clearance of Indocyanine Green calculated using data collected in the first 20 min after injection overestimated that calculated using data collected for as long as Indocyanine Green was measurable in the plasma. In the patients with cirrhosis the mean overestimate was 87%. 6. Thus, a two-compartment pharmacokinetic model was inappropriate for the description of the disposition of Indocyanine Green and estimates of the hepatic extraction ratio obtained using this model in patients with cirrhosis were inaccurate.

Clearance and Non-Invasive Determination of the Hepatic Extraction of Indocyanine Green in Baboons and Man

1983 ◽  
Vol 64 (2) ◽  
pp. 207-212 ◽  
Author(s):  
S. L. Grainger ◽  
P. W. N. Keeling ◽  
I. M. H. Brown ◽  
J. H. Marigold ◽  
R. P. H. Thompson
Keyword(s):  
Indocyanine Green ◽  
Accurate Determination ◽  
Liver Blood Flow ◽  
Compartment Model ◽  
Hepatic Extraction ◽  
Non Invasive ◽  
Two Compartment Model ◽  
Hepatic Extraction Ratio ◽  
Plasma Disappearance Curve

1. The disposition of an intravenous bolus of indocyanine green (ICG) has been studied in healthy man and baboons using a novel analysis of a two compartment pharmacokinetic model. 2. This analysis enabled the hepatic extraction ratio (ER) of dye to be determined solely from the plasma disappearance curve, and the ER determined did not differ from that measured by hepatic vein catheterization. 3. When compared with clearance measured at steady state, the two compartment model gave a significantly more accurate determination of plasma clearance than did the conventional one compartment model. 4. It is concluded that, in health, liver blood flow may be calculated accurately and noninvasively after a single intravenous injection of ICG.

Hepatic removal of two fractions of indocyanine green after bolus injection in anesthetized pigs

1994 ◽  
Vol 266 (6) ◽  
pp. G1108-G1122 ◽  
Author(s):  
P. Ott ◽  
S. Keiding ◽  
A. H. Johnsen ◽  
L. Bass
Keyword(s):  
Indocyanine Green ◽  
Bolus Injection ◽  
Plasma Concentrations ◽  
Hepatic Uptake ◽  
Hepatic Extraction ◽  
First Order ◽  
Extraction Fraction ◽  
Disappearance Curve ◽  
Detailed Mathematical Analysis ◽  
Plasma Disappearance Curve

In the anesthetized pig, we studied the kinetics after intravenous bolus injection of two fractions of indocyanine green (ICG): the genuine ICGg (95-99% of total) and a degradation product, ICGdp (1-5%). Plasma concentrations were followed in the carotid artery and a hepatic vein. ICGg disappearance curves (n = 7) were biexponential with rate constants alpha = 0.189 +/- 0.021 min-1 and beta = 0.0356 +/- 0.0061 min-1. The hepatic extraction fraction was constant with time. A detailed mathematical analysis showed this to be in disagreement with the conventional assumption that the biexponential plasma disappearance curve is a result of backflux from the liver storage to plasma. In contrast, our observations were predicted by an alternative model assuming temporary extrahepatic, extravasal redistribution during first-order, one-way hepatic uptake. Nevertheless, when a large bolus of sulfobromophthalein (BSP) was injected 20 min after ICG, a net backflux of ICG could be demonstrated, presumably due to countertransport. Thus a sufficient description of ICGg kinetics must include the complex kinetic behavior of the hepatic membrane carrier involved. Mass spectrometry suggested that ICGdp is formed by two ICGg molecules. Plasma elimination of ICGdp was slower (alpha = 0.0094 +/- 0.0007 min-1). Analysis of the bile after bolus injection (n = 2) of ICGdp revealed two possible metabolites of ICGdp that were not found in urine. Since BSP injection did not alter the ICGdp disappearance curve, ICGdp is probably not taken up by the same hepatic membrane carrier as ICGg.

Evidence for intestinal release of absorbed selenium in a form with high hepatic extraction

1992 ◽  
Vol 262 (5) ◽  
pp. G854-G858 ◽  
Author(s):  
T. Kato ◽  
R. Read ◽  
J. Rozga ◽  
R. F. Burk
Keyword(s):  
Portal Vein ◽  
Gel Filtration ◽  
Systemic Circulation ◽  
Selenoprotein P ◽  
Intragastric Administration ◽  
Hepatic Extraction ◽  
Extraction Capacity ◽  
Selenium Uptake ◽  
Better Than

Selenium is readily absorbed from the gastrointestinal tract and utilized for synthesis of selenoproteins. Roles of intestine, liver, and selenoprotein P in this process were evaluated. Rats were given 75Se-selenite by stomach tube, and distribution of 75Se was followed for 3 h. A high portal vein plasma-to-hepatic vein plasma ratio of 75Se 15 min after 75Se administration and earlier uptake by liver than by other tissues indicated avid hepatic extraction of absorbed selenium from portal vein blood. The results of gel filtration of plasma taken 15 min after 75Se administration suggested that the 75Se was in the form of small molecules with some affinity for protein. Immunoprecipitation studies using plasma indicated that 75Se began to appear in selenoprotein P between 15 and 30 min after intragastric administration. To evaluate the role of the liver in the fate of absorbed selenium, rats with portacaval shunts, in which absorbed selenium bypasses the liver, were compared with sham-operated rats. After intragastric administration of selenium, uptake by the liver and incorporation into selenoprotein P were diminished in rats with portacaval shunts but kidney uptake and urinary excretion were increased. This suggests that hepatic extraction of absorbed selenium from portal vein blood decreases its entrance into the systemic circulation. The results of this study indicate that intestine releases absorbed selenium into portal blood in a small-molecule form, designated A-Se, which is highly extracted by the liver. The liver takes up A-Se better than other tissues because of a high extraction capacity and the fact that it is the first organ through which the blood from the intestine passes.

scholarly journals Intravenous Glucose Administration in Fasting Rats Has Differential Effects on Acylated and Unacylated Ghrelin in the Portal and Systemic Circulation: A Comparison between Portal and Peripheral Concentrations in Anesthetized Rats

Endocrinology ◽  
2007 ◽  
Vol 148 (11) ◽  
pp. 5278-5287 ◽  
Author(s):  
Carlotta Gauna ◽  
Piet Uitterlinden ◽  
Piet Kramer ◽  
Rosalie M. Kiewiet ◽  
Joop A. M. J. L. Janssen ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Metabolic Regulation ◽  
Glucose Tolerance Test ◽  
Hepatic Clearance ◽  
Systemic Circulation ◽  
Tolerance Test ◽  
Hepatic Extraction ◽  
Intravenous Glucose ◽  
Nutritional Factors ◽  
Unacylated Ghrelin

Ghrelin is produced by the gastrointestinal tract, and its systemic concentrations are mainly regulated by nutritional factors. Our aim was to investigate: 1) endogenous portal and systemic acylated and unacylated ghrelin levels (AG and UAG, respectively); 2) whether an iv glucose tolerance test (IVGTT) modifies AG and UAG; and 3) whether the liver passage plays a role in regulating systemic AG and UAG. To elucidate this, we evaluated the effects of IVGTT or saline injection on endogenous portal and systemic concentrations of glucose, insulin, AG, and UAG in anesthetized fasting rats. Hepatic extraction of insulin, AG, and UAG and the ratio of AG to UAG were also measured. IVGTT suppressed both portal (P < 0.03) and peripheral (P < 0.05) UAG, whereas it only blunted prehepatic, but not peripheral, AG. During fasting, hepatic clearance of UAG was 11%, and it was decreased to 8% by IVGTT. AG was cleared by the liver by 38% but unaffected by glucose. The AG to UAG ratio was higher in the portal than the systemic circulation, both in the saline (P < 0.004) and IVGTT (P < 0.0005) rats. In conclusion, this study shows that: 1) the ratio of AG to UAG is very low in the portal vein and decreases further in the systemic circulation; 2) IVGTT in anesthetized fasting rats inhibits UAG, whereas it only blunts prehepatic, but not systemic, AG; and 3) hepatic clearance of AG is much higher than that of UAG. Thus, our results suggest that peripheral AG metabolic regulation and action are mainly confined within the gastrointestinal tract.

Assessment of Liver Function prior to Hepatic Resection

Swiss Surgery ◽  
1999 ◽  
Vol 5 (3) ◽  
pp. 92-96 ◽  
Author(s):  
Lauterburg
Keyword(s):  
Indocyanine Green ◽  
Hepatic Resection ◽  
Partial Hepatectomy ◽  
Volume Fraction ◽  
Portal Pressure ◽  
Preoperative Assessment ◽  
Hepatic Function ◽  
Oral Glucose ◽  
Selection Of Patients ◽  
Selection Of

Improved surgical technique, improved anesthesia, better postoperative care and better selection of patients have all contributed to the marked decrease in mortality of partial hepatectomy over the past few years. Preoperative assessment of portal pressure and of hepatic function with indocyanine green and an oral glucose load can help identify patients who will not tolerate a major hepatic resection. The predictive value of the indocyanine green retention can be improved if the volume fraction of the liver remaining after resection is determined preoperatively by computer tomography. Factors other than hepatic function, such as age, concomitant diseases and characteristics of the operation itself, will of course also play an important role in determining the outcome of partial hepatectomy.

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