A New Method to Measure Portal Venous and Hepatic Arterial Blood Flow Patients Intraoperatively

Abstract

The intraoperative measurement of the afferent circulation of the liver, namely the hepatic artery flow and portal venous flow was carried out upon 14 anesthetized patients having carcinoma in the splanchnic area, mainly in the head of the pancreas by means of transit time ultrasonic volume flowmeter. The hepatic artery flow, portal venous flow and total hepatic flow were 0.377+0.10; 0.614+0.21; 0.992+0.276 l/min respectively.The ratio of hepatic arterical flow to portal venous flow was 0.66+0.259There was a sharp, significant increase in hepatic arterial flow (29.8+6.1%, p<0,01) after the temporary occlusion of the portal vein, while the temporary occlusion of hepatic artery did not have any significant effect on portal venous circulation. The interaction between hepatic arterial flow and portal venous flow is a much disputed question, but according to the presented data here, it is unquestionable, that the decrease of portal venous flow immediately results a significant increase in hepatic artery circulation.

Low Molecular Weight Dextran Sulfate: A Strong Candidate Drug to Block IBMIR in Clinical Islet Transplantation

“…In the present study we demonstrate that LMW‐DS is a potent inhibitor of, not only xenogeneic (24) but also of allogeneic IBMIR. LMW‐DS inhibited macroscopic clotting, abrogated platelet consumption and completely blocked the generation of C3a, FXIa‐AT and TAT when human islets came in contact with ABO‐compatible blood.…”

Color Doppler sonography avoids misinterpretation of the ?parallel channel sign? in the sonographic diagnosis of cholestasis

“…15 In liver cirrhosis, the decrease in portal venous blood flow is associated with a compensatory increase in the hepatic arterial blood flow, 16 which may explain the increased visibility of hepatic artery branches in liver cirrhosis and other liver diseases. [17][18][19][20][21] This hypothesis is supported by our finding that 86% of our patients with enlarged hepatic artery branches had an underlying nonbiliary liver disease (eg, liver cirrhosis, liver metastases, or liver abscess). These findings are compatible with those of previous studies indicating increased blood flow in the hepatic artery in patients with decreased portal venous flow due to liver metastases, [18][19][20] hepatocellular carcinoma, 17,19,21 viral hepatitis, 22 or cirrhosis.…”

Lack of a correlation between portal vein flow and pressure: Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation

“…However, veins have limited elasticity once they are fully distended, and at this point, PVP increases rapidly with increased volume 5. After liver transplantation (LT), PVF increases to double the flow observed in healthy subjects because of the loss of normal vascular tone and the persistence of abnormal splanchnic hemodynamics 6‐9. This increased PVF can reduce the hepatic artery flow (HAF) through an intrahepatic arterial buffer response 10‐12.…”