The effects of serum ultrafiltrates and fractions from patients with fulminant hepatic failure (FHF) on bile production in the rat were investigated. When serum ultrafiltrates (mol. wt less than 10,000) were infused into the portal vein bile flow showed a significant decrease with FHF ultrafiltrate (90.4 +/- s.e. 2.0% of baseline at the end of infusion, n = 4) compared with a small increase on infusion of normal ultrafiltrate (107.9 +/- 3.4%, n = 6, P less than 0.025). Bile acid output was significantly decreased by FHF ultrafiltrate (62.0 +/- 2.3%., P less than 0.005). Chromatography of the ultrafiltrates on Sephadex G-25 gave two fractions from FHF serum which produced similar changes as with whole ultrafiltrate on bile secretion. Thus, toxic substances accumulating in the circulation of patients with FHF could reduce bile flow and impair the recovery of hepatic function.
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