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

The vasodilative action of prostaglandin E1 (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 microgram/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.