Enhanced portal flow velocity and volume following Iloprost treatment

Objective: We studied, with color Doppler sonography, portal flow velocity (PV) and volume (PFV) before and after Iloprost infusion. Background: Iloprost is a prostacyclin analogue with arterial vasodilator and platelet aggregation inhibitor properties. Recently, hemodynamic effects after treatment with Iloprost have been demonstrated in subjects with arteriopathy of lower limbs. Methods: We treated 10 subjects (2 males and 8 females; mean age 64±8.2 years) affected by arteriopathy of lower limbs with intravenous infusion of Iloprost, at a dosage of 2 ng/Kg/min (16 hours/day) for 3 days. In all patients portal vein flow velocity (PV) (cm/s) and volume (PFV) (ml/min) were assessed. PV was directly determined by the Doppler system, whereas PFV was calculated using the formula "CSA × PV", after measuring the portal vein cross sectional area (CSA) (mm2). Results: The patients showed markedly increased PV and PFV after Iloprost infusion (pre-Iloprost vs post-Iloprost treatment mean portal flow velocity and volume values: 23.12±3.89 cm/s vs 28.49±3.90 cm/s, p<0.01 and 1743.9±241.7 ml/min vs 2271.7±333.5 ml/min, p<0.001, respectively). Conclusions: This study confirms our previous results about increased PV and PFV values after Iloprost treatment. In the light of these results we suggest some possible therapeutic implications in patients undergoing liver transplantation. However, further studies are necessary to confirm this hypothesis.