Cimetidine Does Not Reduce Liver Blood Flow in Cirrhosis

Authors

  • J. Michael Henderson,

    Corresponding author
    1. Department of Surgery and the Clinical Research Facility, Emory University School of Medicine, Atlanta, Georgia 30322
    • J. Michael Henderson, F.R.C.S., Department of Surgery, Emory University Hospital, 1364 Clifton Road, NE, Atlanta, Georgia 30322.
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  • Shakir Z. Ibrahim,

    1. Department of Surgery and the Clinical Research Facility, Emory University School of Medicine, Atlanta, Georgia 30322
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  • William J. Millikan Jr.,

    1. Department of Surgery and the Clinical Research Facility, Emory University School of Medicine, Atlanta, Georgia 30322
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  • Michael Santi,

    1. Department of Surgery and the Clinical Research Facility, Emory University School of Medicine, Atlanta, Georgia 30322
    Current affiliation:
    1. 1445 Henry Clay Avenue, New Orleans, Louisiana 70118.
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  • W. Dean Warren

    1. Department of Surgery and the Clinical Research Facility, Emory University School of Medicine, Atlanta, Georgia 30322
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Abstract

Cimetidine has been shown to reduce liver blood flow, as measured by indocyanine green clearance, in normal subjects. Concern over the potential deleterious effects of such reduction in cirrhosis led to the measurement of blood flow in 14 cirrhotics receiving oral or intravenous cimetidine. Liver blood flow was measured by the clearance of galactose at steady state during infusion of 40 mg per min. In six patients receiving 300 mg cimetidine by mouth each 6 hr for 4 days, basal flow (1,019 ± 186 ml per min) was not significantly altered by cimetidine (1,087 ± 156 ml per min). Intravenous infusion of cimetidine (300 mg) did not significantly alter flow in five patients betwen the basal (1,096 ± 334 ml per min) and treatment periods (1,051 ± 383 ml per min). Hepatic extraction of galactose in three patients (82 ± 19%) was not significantly altered by cimetidine infusion (81 ± 13%). The failure to reduce liver blood flow with cimetidine in this population may be due to their diminished proportion of portal venous flow, or alternatively suggests that histamine is not an important modulator of flow via H2 receptors. At a clinical level, the use of cimetidine in this population can continue without fear of further reduction in liver blood flow.

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