Effect of endotoxin and immunoglobulin on the course of experimental hepatic encephalopathy

A single intraperitoneal dose of endotoxin (500 micrograms) shortened the time for development of hepatic coma by 27% in 300-g rats that had an end-to-side portacaval shunt followed within 48 hr by hepatic artery ligation. The body temperature of the rats was maintained at 37 degrees C, and the endotoxin was injected just after the hepatic artery was ligated. Controls were injected similarly with saline. The time to death was also shortened by 27%. A single intravenous dose of immunoglobulin (150 mg) delayed the time from the massive hepatic ischemia to the onset of hepatic coma by 19%. The immunoglobulin was injected just after the portacaval shunt was completed. Controls were injected similarly with 0.6 ml of 25% human serum albumin. While not large, these opposite effects of endotoxin and immunoglobulin were highly significant statistically. These observations complement the findings in human liver failure.