The effect of a long-acting somatostatin analogue on portal and systemic haemodynamics in cirrhosis.

Current interest in the pharmacological manipulation of portal pressure centres on the long-acting somatostatin analogue SMS 201-995. Nine haemodynamically stable cirrhotic patients who had previously bled from oesophageal varices had wedged and free hepatic venous pressures and cardiac index measured, using a Swan-Ganz catheter, before and at 60, 120 and 180 min after beginning a 60-min infusion of 25 microgram/h of SMS 201-995. Seven clinically similar patients had the same measurements performed without SMS 201-995. In all patients cardiac index was found to decrease and systemic vascular resistance increase at 60 min, although heart rates and arterial blood pressures were unchanged. The group given SMS 201-995 was significantly different from the control group in sustaining a fall in wedged hepatic venous pressure and trans-hepatic venous gradient at 60 min. SMS 201-995 causes a fall in portal pressure without a significant systemic haemodynamic effect.