Liver function after aortic reconstruction for aortic dissection. Especially with reference to liver blood flow from fales lumen.

ABSTRACT Sordarin derivatives constitute a new group of synthetic antifungal agents that selectively inhibit fungal protein synthesis. They have demonstrated in vitro activity against the most important fungal pathogens, both yeast and filamentous. This new family of compounds has also shown in vivo activity against murineCandida albicans, Histoplasma capsulatum, andCoccidioides immitis experimental infections, as well as against Pneumocystis carinii pneumonia in rats. After intravenous dosing in animals, both the area under the concentration-time curve and the elimination half-life were highest in Cynomolgus monkeys, followed by those in rats, mice, and rabbits. The volume of distribution at steady state for sordarin derivatives was similar in all species tested. The clearance in rats and mice was higher than for other species. GM 237354, a sordarin derivative, was characterized by high serum protein binding in mouse, rat, and monkey serum (unbound fraction, ≤5%). An indirect evaluation of the effect of liver function upon the metabolism of this class of compounds has been made in animals with impaired liver function such as Gunn rats, as well as in allometric studies that showed better correlations of half-life to liver blood flow than to animal body weight. Linearity of the main pharmacokinetic parameters was demonstrated after intravenous dosing of the representative compound GM 193663 at 10 and 20 mg/kg of body weight in rats. Allometry was used to determine whether human pharmacokinetic parameters can be predicted from animal data by regression analysis against body weight and liver blood flow. All these results have demonstrated that the human pharmacokinetics of sordarin derivatives can be forecast from animal data.

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Hepatic function in the critically ill

10.1093/med/9780199600830.003.0175 ◽

2016 ◽

Author(s):

Andreas Kortgen ◽

Michael Bauer

Keyword(s):

Blood Flow ◽

Liver Function ◽

Critically Ill ◽

Liver Blood Flow ◽

Prognostic Significance ◽

Liver Function Tests ◽

Hepatic Function ◽

Prognostic Information ◽

Hepatocellular Damage ◽

Function Tests

The liver with its parenchymal and non-parenchymal cells plays a key role in the organism with manifold functions of metabolism, synthesis, detoxification, excretion, and host response. This requires a portfolio of different tests to obtain an overview of hepatic function. In the critically ill hepatic dysfunction is common and potentially leading to extrahepatic organ dysfunctions culminating in multi-organ failure. Conventional laboratory measures are used to evaluate hepatocellular damage, cholestasis, or synthesis. They provide valuable (differential) diagnostic data and can yield prognostic information in chronic liver diseases, especially when used in scoring systems such as the ‘model for end-stage liver disease’. However, they have short-comings in the critically ill in assessing rapid changes in hepatic function and liver blood flow. In contrast, dynamic quantitative liver function tests measure current liver function with respect to the ability to eliminate and/or metabolize a specific substance. In addition, they are dependent on sinusoidal blood flow. Liver function tests have prognostic significance in the critically ill and may be used to guide therapy.

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The Risk Of Surgery In Patients With Liver Disease 1: Epidemiology, Pathophysiology, And Pre-Operative Evaluation

10.2310/gastro.5481 ◽

2018 ◽

Author(s):

Adrian Reuben

Keyword(s):

Blood Flow ◽

Liver Disease ◽

Liver Function ◽

Large Scale ◽

Venous Pressure ◽

Liver Blood Flow ◽

Disease Patient ◽

Case Series ◽

Kidney Injury ◽

Operative Evaluation

The results of retrospective large scale registry and cohort studies, and small case series, substantiate the common perception that operating on a liver disease patient is risky. The preexisting physiological derangements of liver disease may be exacerbated by the trauma of surgery and its complications, which contributes strongly to the aforementioned surgical risks, especially (but not exclusively) in cirrhotics. Perturbations in liver blood flow and oxygenation may be exaggerated by anesthesia, surgery itself, blood loss, and other operative complications. Cirrhotics are especially susceptible to acute and chronic kidney injury. Malnutrition is common in cirrhosis, which compromises wound healing and recovery from surgery. In cirrhosis, elimination of infection is impaired and its systemic effects are deleterious. The metabolic and immunological stresses of surgery may lead to liver function deterioration, even in stable cirrhotics. Presented here is the pre-operative evaluation of liver disease patients, including the use of predictive indices, new dynamic tests of liver function, and modestly invasive assessment of portal hypertension. This review contains 9 figures, 6 tables and 52 references Keywords: acute-on-chronic liver failure, Child-Turcotte-Pugh, cirrhosis, coagulopathy, infection, hepatic venous pressure gradient, liver blood flow, model for end-stage liver disease, systemic inflammatory response syndrome, thrombocytopenia

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The Risk Of Surgery In Patients With Liver Disease 1: Epidemiology, Pathophysiology, And Pre-Operative Evaluation

10.2310/im.5481 ◽

2018 ◽

Author(s):

Adrian Reuben

Keyword(s):

Blood Flow ◽

Liver Disease ◽

Liver Function ◽

Large Scale ◽

Venous Pressure ◽

Liver Blood Flow ◽

Disease Patient ◽

Case Series ◽

Kidney Injury ◽

Operative Evaluation

The results of retrospective large scale registry and cohort studies, and small case series, substantiate the common perception that operating on a liver disease patient is risky. The preexisting physiological derangements of liver disease may be exacerbated by the trauma of surgery and its complications, which contributes strongly to the aforementioned surgical risks, especially (but not exclusively) in cirrhotics. Perturbations in liver blood flow and oxygenation may be exaggerated by anesthesia, surgery itself, blood loss, and other operative complications. Cirrhotics are especially susceptible to acute and chronic kidney injury. Malnutrition is common in cirrhosis, which compromises wound healing and recovery from surgery. In cirrhosis, elimination of infection is impaired and its systemic effects are deleterious. The metabolic and immunological stresses of surgery may lead to liver function deterioration, even in stable cirrhotics. Presented here is the pre-operative evaluation of liver disease patients, including the use of predictive indices, new dynamic tests of liver function, and modestly invasive assessment of portal hypertension. This review contains 9 figures, 6 tables and 52 references Keywords: acute-on-chronic liver failure, Child-Turcotte-Pugh, cirrhosis, coagulopathy, infection, hepatic venous pressure gradient, liver blood flow, model for end-stage liver disease, systemic inflammatory response syndrome, thrombocytopenia

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Chronic Portal Venous Hypertension: The Effect on Liver Blood Flow and Liver Function and the Development of Esophageal Varices

Scandinavian Journal of Gastroenterology ◽

10.3109/00365528708991492 ◽

1987 ◽

Vol 22 (4) ◽

pp. 463-470 ◽

Cited By ~ 13

Author(s):

L. S. Jensen ◽

N. Krarup ◽

J. Anker Larsen ◽

C. Juhl ◽

T. Harboe Nielsen ◽

...

Keyword(s):

Blood Flow ◽

Liver Function ◽

Esophageal Varices ◽

Liver Blood Flow ◽

Venous Hypertension ◽

Portal Venous Hypertension

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N-acetylcysteine increases liver blood flow and improves liver function in septic shock patients: Results of a prospective, randomized, double-blind study

Critical Care Medicine ◽

10.1097/00003246-200012000-00006 ◽

2000 ◽

Vol 28 (12) ◽

pp. 3799-3807 ◽

Cited By ~ 115

Author(s):

Nikolaus Rank ◽

Christian Michel ◽

Corina Haertel ◽

Cand Med ◽

Andreas Lenhart ◽

...

Keyword(s):

Septic Shock ◽

Blood Flow ◽

Liver Function ◽

Liver Blood Flow ◽

Blind Study ◽

Double Blind Study ◽

Double Blind

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Liver Blood Flow as a Major Determinant of the Clearance of Recombinant Human Tissue-Type Plasminogen Activator

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648385 ◽

1992 ◽

Vol 67 (01) ◽

pp. 083-087 ◽

Cited By ~ 44

Author(s):

A de Boer ◽

C Kluft ◽

J M Kroon ◽

F J Kasper ◽

H C Schoemaker ◽

...

Keyword(s):

Blood Flow ◽

Rat Liver ◽

Healthy Subjects ◽

Liver Blood Flow ◽

Major Determinant ◽

Tissue Type ◽

Perfused Rat Liver ◽

Liver Model ◽

Type Plasminogen Activator ◽

Proportional Change

SummaryThe influence of changes in liver blood flow on the clearance of rt-PA was studied both in healthy subjects and in a perfused rat liver model. Liver blood flow in healthy subjects was documented indirectly by the clearance of indocyanine green (ICG). Exercise reduced liver blood flow on average by 57% with a 95% confidence interval (95% Cl) ranging from 51% to 62% (n = 5) and increased plasma levels of rt-PA activity (after an i. v. infusion of 18 mg of rt-PA over 120 min) by 119% (95% Cl, 58% - 203%) and rt-PA antigen by 91% (95% Cl, 30% - 140%). In the perfused rat liver model it was shown that halving or doubling of the physiological flow rate of a perfusate, containing rt-PA caused a proportional change in the clearance of rt-PA, while the extraction of rt-PA by the liver remained similar. In conclusion, liver blood flow is a major determinant of the clearance of rt-PA. This may have important implications for dosage of rt-PA in patients with myocardial infarction.

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