Compartmental Analysis of Sulfobromophthalein Transport in Normal Patients and Patients with Hepatic Dysfunction

The plasma disappearance curve following a single intravenous injection of sulfobromophthalein (BSP) was analyzed by an established computer technique and BSP kinetics evaluated for 10 normal control subjects and 16 patients with various hepatic disorders. The two-compartment model used in this analysis was supported by the findings of constant fractional transport rates for different injected BSP doses and close simulations of experimental plasma and biliary data. Four fractional transport rates were determined for the two-pool system: (1) fractional hepatic removal rate; (2) fractional hepatic plasma reflux rate; (3) fractional biliary secretory rate; and (4) fractional urinary excretion rate. Mean values and per cent fractional standard deviation for the four respective rates in normal subjects are: (1) 0.14 min^-1 (11%); (2) 0.013 min^-1 (25%); (3) 0.036 min^-1 (16%); (4) 0.0009 min^-1. The corresponding mean rates for 7 patients with biopsyproved portal cirrhosis are: (1) 0.046 min^-1 (19%); (2) 0.024 min^-1 (35%); (3) 0.018 min^-1 (25%); (4) 0.0008 min^-1. The respective means for 4 patients with biopsy-documented viral hepatitis are: (1) 0.041 min^-1 (15%); (2) 0.021 min^-1 (26%); (3) 0.004 min^-1 (42%); (4) 0.0007 min^-1. Changes in these parameters were monitored serially during the clinical course of patients with acute hepatic necrosis. This kinetic approach was compared with previous evaluations of BSP transport in man by a constant infusion technique and similar results were obtained for the two techniques in normal subjects.