The role of portal blood factors in regeneration of the liver

Abstract

A new hepatic blood flow diversion method was undertaken to investigate further the influence of pancreatic hormones and hepatic blood flow on the functional regeneration of the liver. The new technique does not use venograft. The splenic vein was dissected and anastomosed to the proximal portal vein, which supplied the right lobes, and the mesenteric vein was dissected and anatomosed to the left portal vein at the hilus of the liver, which supplied the left lobes. Mongrel dogs weighing approximately 10 kg were used. The right lobe received pancreatico‐gastrosplenic blood. The left lobe received intestinal blood. After hepatectomy, which removed 10% from the right side and 40% from the left side, blood flow volume to the right and left lobes was almost equal. The right lobes increased in weight significantly more than the left lobes. The extraction rates of indocyanine green of the right and left lobes were not significantly different. The right lobe revealed typical regeneration histologically, but the left lobe showed no signs of atrophy. Although pancreatic hormones were sufficiently supplied to the left lobe through the hepatic artery, they were not degraded. Pancreatic hormones could be a modifying factor affecting the quantity of hepatic regeneration. The study of both the quantity and the functional quality of the regenerated liver is important.

Preoperative estimation of the liver graft weight in adult right lobe living donor liver transplantation using maximal portal vein diameters

“…The sizes of the 2 portal veins and their blood flow should also be proportional to the metabolic and nutritional demands of the liver lobes. This hypothesis is indirectly supported by some earlier animal studies by Child et al,16 Sgro et al,17 and Takeshige et al,18 who suggested that the volume of the portal blood flow is the most important factor for liver regeneration.…”

Preoperative estimation of hemi-liver volume using standard liver volume and portal vein diameter ratio in living donor liver transplantation

“…Sizes of the two portal 95% prediction interval 95% confidence interval veins and their blood flow were proportional to metabolic and nutritional demands of hemi-livers. This concept is indirectly supported by some earlier animal studies, suggesting that the volume of the portal blood flow is the most important factor for liver regeneration [8,14].…”

“…Such type of liver volumetric measurement is a time-consuming procedure. Considering that portal blood flow into the hemi-liver is correlated with the HLV [ 7 - 9 ], it is possible to estimate volumetric proportions of hemi-livers using right portal vein diameter (RPVD) and left portal vein diameter (LPVD). The aim of this study was to validate the reliability of portal vein diameter comparison method for assessing HLVs in living liver donors.…”