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The bromsulphalein method of estimating liver blood flow in man first introduced by Bradley, Ingelfinger, Bradley, and Curry (1) has proved to be a very useful tool in the hands of various workers. Though there is not complete agreement as to the question of extrahepatic dye loss and the problem of a single hepatic vein sample not being entirely representative of all the blood leaving the liver, a considerable amount of information has been gathered by studying the state of liver circulation in normal and diseased subjects and its alterations produced by exercise, posture, anesthesia , and various drugs. However, the tech-nic employed is by no means a simple one and requires the team work of several highly trained people. Very recently, an entirely different method has been applied to the study of hepatic circulation. It is based on the assumption that the phagocytes of liver and spleen are highly efficient in removing colloid particulate matter from the blood stream in a single passage. If this assumption holds true, then the disappearance rate of this colloid from the circulation would essentially be a parameter of liver blood flow. Since the liver and spleen are in series with each other and since the bone marrow takes up only minimal amounts of this col-loid, it was felt by Sheppard, Jordan, and Hahn (2) that it should be possible to calculate liver blood flow from the disappearance rate constant as the fraction of blood volume perfusing the liver per unit time. This idea has been put into practice (3) who used chromic phosphate labeled with radiophosphorus as the particulate matter. However , this method again appears not to be as simple as one would want it to be for a routine diagnostic procedure. The preparation of a chromic phosphate colloid of suitable particle size is quite a laborious procedure, and the determination of the disappearance rate itself involves the withdrawal of serial blood samples which, to the patient, results in the loss of a considerable amount of blood. A further simplification of the estimation of liver blood flow in man would, therefore, be afforded by using a colloid readily at hand, and by labeling it with a Remitting isotope which would permit external determination of the disappearance rate without the need for withdrawing blood samples. The present paper reports some results obtained with colloidal radioactive gold (Au198) used as the particulate matter, the …

the journal of clinical investigation/the journal of clinical investigation

The Disappearance Rate of Colloidal Radiogold from the Circulation and Its Application to the Estimation of Liver Blood Flow in Normal and Cirrhotic Subjects