Dibromsulphalein (DBSP) Estimation of Hepatic Transport Function in Man*

Abstract

Abstract. Bromsulphalein (BSP) and dibromsulphalein (DBSP) were given separately in equimolar amounts by intravenous injection or infusion to 15 apparently healthy individuals and 33 individuals with hepatobiliary disease. The slope (K) of the plasma disappearance rate, the relative storage capacity (S) and the maximum biliary excretion rate (Tm) for both BSP and DBSP were calculated and the mean values for each group determined.—In the normal group, K for DBSP, 0.234 ± 0.023 (1 SD), was found to be significantly greater than K for BSP, 0.151 ± 0.042, indicating a more rapid plasma disappearance rate for DBSP. Similarly, S was significantly higher for DBSP, 124.6 ± 56.6 μmol/μmol/100 ml, than for BSP, 67.7 ± 34.1. The Tm for DBSP however, 10.9 ± 1.6 μmol/min., was not significantly different from that for BSP, 9.5 ± 1.7.—In the patients with cirrhosis, there was reduction in K, S, and Tm, which was of the same order of magnitude for both dyes, indicating that DBSP is as sensitive as BSP in the detection of liver disease. Since DBSP is not conjugated in vivo, this suggests that the modifications of BSP disposition in cirrhosis are attributable primarily to a defect in the transport function of the liver cell. Defective conjugation of BSP therefore probably does not contribute importantly to the BSP abnormalities observed in cirrhotic patients.