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Agonal hepatic arterial vasospasm.

A M D'Alessandro1, R J Stratta, J H Southard

  • 1Department of Surgery, University of Wisconsin School of Medicine, Madison.

Surgery, Gynecology & Obstetrics
|October 1, 1989
PubMed
Summary
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Dibenzyline (phenoxybenzamine) prevents hepatic arterial vasospasm during asphyxia in pigs. This finding suggests alpha-adrenergic antagonists could improve organ procurement and early liver transplant function.

Area of Science:

  • Transplantation immunology
  • Vascular physiology
  • Surgical research

Background:

  • Agonal states can induce hepatic arterial vasospasm, potentially impairing organ viability.
  • Alpha-adrenergic antagonists are known to cause vasodilation.

Purpose of the Study:

  • To investigate the effect of Dibenzyline (phenoxybenzamine) on preventing hepatic arterial vasospasm in a porcine model of agonal asphyxia.
  • To assess the impact of Dibenzyline on hepatic arterial blood flow during asphyxia.

Main Methods:

  • A porcine model of asphyxia-induced hepatectomy was used.
  • Pigs were divided into two groups: one without Dibenzyline pretreatment and one pretreated with Dibenzyline (2 mg/kg).
  • Hepatic arterial blood flow was measured using an electromagnetic flow probe, and arteriograms were obtained post-cardiac arrest.

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Main Results:

  • Hepatic arterial vasospasm occurred in 7/9 non-pretreated pigs versus 1/6 Dibenzyline-pretreated pigs (p<0.05).
  • Agonal hepatic arterial blood flow was significantly higher in pretreated pigs (415 ± 30 ml/min) compared to non-pretreated pigs (98.6 ± 63.3 ml/min) (p<0.05).

Conclusions:

  • Dibenzyline effectively prevents agonal hepatic arterial vasospasm in this porcine model.
  • Donor pretreatment with alpha-adrenergic antagonists may be beneficial in clinical organ procurement to mitigate vasospasm and improve early hepatic allograft function.