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Assessment of the hepatic circulation in humans: new concepts based on evidence derived from a D-sorbitol clearance method.

The Journal of laboratory and clinical medicine (1998-05-30)
G Molino, P Avagnina, G Belforte, J Bircher
ABSTRACT

D-Sorbitol (SOR) is safe, is easy to measure, and has an exceptionally high extraction ratio in the normal liver of 0.93+/-0.05 (mean+/-SD). Together with the general interest in hepatic hemodynamics, these facts motivated us to review the usefulness of this compound for the assessment of liver plasma flow in humans. We concluded that in subjects without liver disease the nonrenal clearance of SOR-measured noninvasively-very closely approximates hepatic plasma flow. Because of its lower and more variable extraction ratio, indocyanine green should no longer be used without hepatic vein catheterization. Even in patients with cirrhosis, SOR exhibits higher hepatic extraction ratios than indocyanine green. To fully explore the potential of SOR in the evaluation of such patients attention needs to be paid to the complex changes in architecture and function occurring in this disease. In cirrhotics the noninvasively measured nonrenal clearance of SOR presumably approximates the flow through intact and capillarized sinusoids (functional flow) and reflects the amount of blood having functional contact with hepatocytes. The theoretic background of the method, its accuracy, further research needs, and potentials of various approaches are discussed in detail.

MATERIALS
Product Number
Brand
Product Description

Sorbitol, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
D-Sorbitol, Vetec, reagent grade, 97%
USP
Sorbitol, United States Pharmacopeia (USP) Reference Standard
Supelco
Sorbitol, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Sorbitol F solution, 70 wt. % in H2O, Contains mainly D-sorbitol with lesser amounts of other hydrogenated oligosaccharides
Sigma-Aldrich
D-Sorbitol, FCC, FG
Sigma-Aldrich
D-Sorbitol, 99%
Sigma-Aldrich
D-Sorbitol, liquid, tested according to Ph. Eur.
Supelco
D-Sorbitol, analytical standard
Sigma-Aldrich
D-Sorbitol, BioReagent, suitable for cell culture, suitable for plant cell culture
Sigma-Aldrich
D-Sorbitol, BioXtra, ≥98%
Sigma-Aldrich
D-Sorbitol, ≥98%
Sigma-Aldrich
D-Sorbitol, for molecular biology, ≥98%
Sigma-Aldrich
D-Sorbitol, BioUltra, ≥99.0% (HPLC)