Effect of Terlipressin Administration on Portal Pressure in Patients with Liver Cirrhosis

Baik, Soon Koo; Kim, Young Ju; Park, Joong Wha; Seo, Jung In; Jeong, Pil Ho; Kim, Moon Young; Park, Dong Hun; Kim, Hyun Soo; Lee, Dong Ki; Kwon, Sang Ok

Abstract

BACKGROUND/AIMS: We conducted this prospective study to evaluate portal hypotensive effect of terlipressin in patients with liver cirrhosis and to find out the factors that contribute to effective reduction of portal pressure after terlipressin administration.
METHODS
A total of 34 patients with cirrhosis who have experienced variceal bleeding were selected. We measured the mean blood pressure (MBP), heart rate (HR), hepatic venous pressure gradient (HVPG), and portal venous flow (PVF) before and 5, 10, 15, 20 minutes after terlipressin administration. Patients who showed an average HVPG reduction of >or= 20% from 5 min to 20 min after terlipressin administration were defined as responder.
RESULTS
At 5 minutes after terlipressin administration, HVPG and PVF decreased from 17.5+/-5.5 mmHg to 14.1+/-4.7 mmHg (-19.4+/-14.8%, p<0.01) and, from 842.6+/-386.0 mL/min to 642.5+/-358.5 mL/min (-25.5+/-12.2%, p<0.01). Elevation of MBP and reduction of HR started after 5 min (p<0.01) and sustained until 20 min. Twenty six patients (76.5%) were classified as responder. In multivariate analysis to identify factors which affect responder, only the Child-Pugh score was a significantly independent factor for responder (Child-Pugh score < 10, odds ratio 135.3, 95% CI [2.45, 7472.33], p=0.016).
CONCLUSIONS
Terlipressin might be helpful in control of variceal bleeding due to reducing portal pressure and more effective in cirrhotic patients with a low Child-Pugh score.