Functional significance of hepatic arterial flow reserve in patients with cirrhosis

Zipprich, Alexander; Steudel, Norbert; Behrmann, Curd; Meiß, Frank; Sziegoleit, Ursula; Fleig, Wolfgang E.; Kleber, Gerhard

doi:10.1053/jhep.2003.50065

Cited by 47 publications

(34 citation statements)

References 39 publications

(52 reference statements)

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“…The reduction in portal venous blood flow may be compensated by increased arterial flow (i.e., the hepatic arterial buffer response). Indeed, the arterial buffer response may have important impact on the hepatic blood-flow and portal pressure in liver cirrhosis [58]. However, in the present portally perfused liver, the oxygen supply was enough by bubbling the perfusing blood in the reservoir with 95% O 2 and 5% CO 2 , which could provide perfusate oxygen tension of approximately 290 mmHg [47].…”

Section: Limitationsmentioning

confidence: 77%

Increased sinusoidal resistance is responsible for the basal state and endothelin-induced venoconstriction in perfused cirrhotic rat liver

Shibamoto

Kamikado

Koyama³

2008

Pflugers Arch - Eur J Physiol

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The localization of increased intrahepatic vascular resistance and the segmental vascular responsiveness to endothelin-1 are not well known in liver cirrhosis. We determined the segmental vascular resistances and their response to endothelin-1 of isolated portally perfused bile duct ligation (BDL)-induced cirrhotic rat livers. The portal occlusion pressure (Ppo) and the hepatic venous occlusion pressure (Phvo) were obtained by analyzing the profiles of the portal (Ppv) and hepatic venous (Phv) pressures during the double occlusion maneuver of simultaneous occlusions of the inflow and outflow perfusion lines. From the pressure gradients among Ppv, Ppo, Phvo, and Phv, the portal-hepatic venous resistance was assigned to three segments of the portal [Rpv = (Ppv - Ppo)/blood flow (Q)], sinusoidal [Rsinus = (Ppo - Phvo)/Q] and hepatic venous [Rhv = (Phvo - Phv)/Q] resistances. Rsinus, but not Rpv or Rhv, was significantly greater in BDL livers than in sham livers. Endothelin-1 (0.1-1 nM) increased Rpv and Rsinus to a similar magnitude, but not Rhv, in both sham and BDL. At 3 nM, the responsiveness of Rpv was smaller in BDL than in sham, but that of Rsinus were similar between in BDL and sham. In conclusion, increased sinusoidal resistance accounts for increased intrahepatic resistance of BDL-induced liver cirrhosis. Endothelin-1 contracts portal veins and sinusoids, but not hepatic veins, in both sham and cirrhotic livers. Sinusoidal contractility to endothelin-1 is not impaired in cirrhotic livers.

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Section: Limitationsmentioning

confidence: 77%

Increased sinusoidal resistance is responsible for the basal state and endothelin-induced venoconstriction in perfused cirrhotic rat liver

Shibamoto

Kamikado

Koyama³

2008

Pflugers Arch - Eur J Physiol

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“…This reduction, through a multifactorial mechanism, results in increased hepatic arterial flow [30][31][32][33][34][35]. The most well-accepted theory involves washout of adenosine, as described by Lautt [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

et al. 2016

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Angioscintigraphy could show that patients with HSS had increased HPI, featuring greater liver "arterialization," as previously described for cirrhotic patients. Correlations were also observed between HPI and longitudinal splenic length, caliber of esophageal varices, caliber of portal vein, and blood platelet count. Angioscintigraphy is a promising technique for evaluation of hepatosplenic schistosomiasis.

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“…The pressure of the portal vein decreased after microwave ablation of the spleen, which helped to relieve the hepatic parenchymal congestion and hepatocyte swelling (28,29). The blood flow was reduced in the portal vein, and subsequently increased in the hepatic artery, and therefore liver regeneration became more active due to enhanced oxygen exchange of the hepatic cells with markedly improved liver function (30).…”

Section: Discussionmentioning

confidence: 99%

Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study

Han

Kong

Ding

et al. 2016

Molecular and Clinical Oncology

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Abstract. The present retrospective study aimed to investigate the mid-term safety and efficacy of hepatectomy combined with microwave ablation of the partial spleen for treatment of liver cancer complicated with hypersplenism. A retrospective analysis was performed on 23 patients who underwent hepatectomy combined with microwave ablation of the partial spleen for liver cancer, complicated with hypersplenism that was secondary to cirrhosis. The splenic and ablated volumes were calculated according to a contrast-enhanced computed tomography scan prior to and 2 weeks after the operation. Complete blood count and liver function tests were examined prior to and following the surgery, and complications and changes in the blood tests were monitored for 6 months. Over this period of investigation, the splenic volume was reduced by a mean value of 34.0%. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased on the first day after the operation (P<0.05), although they recovered to the normal level within 1 week (P<0.05). The total level of bilirubin increased slightly, along with moderately decreased levels of albumin and cholinesterase on the first day, although these changes were not significant compared with the baseline (P>0.05). The white blood cell count was persistently significantly higher compared with the baseline over the course of the 6 months (P>0.05). The platelet count did not increase significantly for the first week after the operation (P>0.05); however, it was revealed to be significantly increased 1 month after the surgery (P<0.05). No significant complications were occurred during the follow-up period. In conclusion, hepatectomy combined with microwave ablation of the spleen was demonstrated to be a safe and effective procedure for patients with liver cancer and hypersplenism in the mid-term.

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Functional significance of hepatic arterial flow reserve in patients with cirrhosis

Cited by 47 publications

References 39 publications

Increased sinusoidal resistance is responsible for the basal state and endothelin-induced venoconstriction in perfused cirrhotic rat liver

Increased sinusoidal resistance is responsible for the basal state and endothelin-induced venoconstriction in perfused cirrhotic rat liver

Increased Hepatic Arterial Blood Flow Measured by Hepatic Perfusion Index in Hepatosplenic Schistosomiasis: New Concepts for an Old Disease

Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study

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