ABSTRACT
Chronic administration of cyclosporin A may induce cholestasis in a few patients. The purpose of this study was to examine the effect of chronic administration of cyclosporin A on serum bile acid levels, serum bilirubin concentration, and bromosulfophthalein plasmatic fractional clearance. Twenty heart-transplanted patients with normal serum alanine aminotransferase activity receiving cyclosporine A during a mean duration of 33 months (range 7-54) were compared to 20 matched kidney-transplanted patients with normal serum alanine aminotransferase receiving azathioprine for a mean duration of 34 months (range 6-72). As compared to azathioprine-treated patients, patients treated with cyclosporin A had an increase in serum bile acid levels of 32% (P < 0.01), an increase in serum bilirubin concentration of 100% (P < 0.001), and a decrease in bromosulfophthalein plasmatic fractional clearance of 60% (P < 0.001). These results suggest that cyclosporin A induces a decrease in hepatic excretory function in man.
Subject(s)
Bile Acids and Salts/blood , Bilirubin/blood , Cyclosporine/administration & dosage , Heart Transplantation , Liver/drug effects , Sulfobromophthalein/metabolism , Adolescent , Adult , Alanine Transaminase/blood , Azathioprine/pharmacology , Fasting , Female , Humans , Liver/metabolism , Male , Middle AgedSubject(s)
Heart Transplantation/adverse effects , Hepatitis B/epidemiology , Transfusion Reaction , Adult , DNA, Viral/blood , DNA, Viral/genetics , Hepatitis B/etiology , Hepatitis B/genetics , Hepatitis B/transmission , Hepatitis B Antigens/blood , Hepatitis B virus/genetics , Humans , Nucleic Acid Hybridization , Polymerase Chain Reaction , Prevalence , Prospective Studies , Retrospective StudiesSubject(s)
Heart Transplantation , Hepatitis B/etiology , Transfusion Reaction , Adult , Blood Donors , Female , Hepatitis B/blood , Humans , MaleABSTRACT
Blood pressures and plasma atrial natriuretic peptide (ANP) concentrations have been measured in venous and intracardiac sites in 11 patients (10 men and 1 woman) given cardiac transplants. The mean plasma ANP level was 214.4 pg.ml-1 in the superior vena cava and 281 pg.ml-1 in the right atrium. This significantly higher level was maintained in the right ventricle (269) and in the pulmonary artery (295). The level in controls was 25 pg.ml-1. Intra cardiac and mean arterial pressures were in normal range in all patients, and there was no correlation between plasma ANP level and intracardiac pressure. The data suggest that in cardiac transplant patients right atrial pressure does not have a primary role in releasing ANP. The transplanted heart is denervated and remains so for many months after operation, thus suggesting that innervation is not obligatory for ANP secretion. Further studies are required to determine the relative contribution of donor and recipient atrial tissues to ANP secretion.
