Vascular Disorders of the Liver

Crawford, James M.

doi:10.1016/j.cld.2010.08.002

Cited by 19 publications

(7 citation statements)

References 29 publications

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“…However, localized hepatic infarcts following thrombosis or compression of an intrahepatic branch of the hepatic artery by various etiologies have been described, and typically lead to a transient increase in transaminases (AST, ALT), without compromising the hepatic synthetic function [10]. …”

Section: Discussionmentioning

confidence: 99%

Isolated Hepatic Artery Thrombosis Leading to Multiple Liver Infarcts in a Non-transplant Patient

Almouradi

Riles

et al. 2014

Am J Case Rep

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Patient: Female, 62Final Diagnosis: Hepatic artery thrombosisSymptoms: Abdominal pain • Nausea • VomitingMedication: —Clinical Procedure: —Specialty: SurgeryObjective:Rare diseaseBackground:Isolated hepatic artery thrombosis is an extremely rare condition with only a few cases reported in the literature.Case Report:A 62-year-old woman presented with a 5-day history of right upper quadrant abdominal pain associated with nausea and vomiting. Physical examination revealed right upper quadrant tenderness.Her initial laboratory work was significant for elevated aspartate aminotransferase and alanine aminotransferase levels (745 and 431 U/L, respectively).A computed tomography of her abdomen showed a thrombus within the hepatic artery, with multiple hepatic infarcts but no evidence of portal vein thrombosis. Hypercoagulability workup was unremarkable; she did not have any evidence of atrial fibrillation on ECG or telemetry. She was treated with subcutaneous low molecular weight heparin.Over the course of her hospitalization, her AST and ALT levels peaked to 2065 and 1217 U/L respectively, and trended down thereafter.Conclusions:We believe that our case is unique for 2 reasons: 1) Our patient did not undergo any procedure that may have precipitated hepatic artery thrombosis and 2) Despite the absence of concurrent portal vein thrombosis, she had biochemical and imaging findings of hepatic ischemia.

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Section: Discussionmentioning

confidence: 99%

Isolated Hepatic Artery Thrombosis Leading to Multiple Liver Infarcts in a Non-transplant Patient

Almouradi

Riles

et al. 2014

Am J Case Rep

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“…The hepatic artery, contributes ~ 30% of the total hepatic blood flow and the portal vein, contributes ~ 70% of the total hepatic blood flow [8]. The intrahepatic branches of the portal vein, hepatic artery, along with the bile duct run together within the portal tract system, branching out through ~ 17–20 orders of branches in order to deliver the entire corpus of the liver [9]. Finally, blood returned to the systemic circulation through at least three distinct hepatic veins (right, middle and left) which drains into the inferior vena cava.…”

Section: Hepatic Vascular Networkmentioning

confidence: 99%

“…The hepatic sinusoids comprise one of the largest-caliber vascular beds in the body [9]. Hepatic sinusoids are the location of pressure equalization between systemic and portal venous flow [10].…”

Section: Hepatic Vascular Networkmentioning

confidence: 99%

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Non-alcoholic fatty liver disease, to struggle with the strangle: Oxygen availability in fatty livers

2017

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Nonalcoholic fatty liver diseases (NAFLD) is one of the most common chronic liver disease in Western countries. Oxygen is a central component of the cellular microenvironment, which participate in the regulation of cell survival, differentiation, functions and energy metabolism. Accordingly, sufficient oxygen supply is an important factor for tissue durability, mainly in highly metabolic tissues, such as the liver. Accumulating evidence from the past few decades provides strong support for the existence of interruptions in oxygen availability in fatty livers. This outcome may be the consequence of both, impaired systemic microcirculation and cellular membrane modifications which occur under steatotic conditions. This review summarizes current knowledge regarding the main factors which can affect oxygen supply in fatty liver.

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“…In general, it occurs in certain cases of extensive alcohol abuse. SAAH frequently presents with other signs of liver failure including encephalopathy, jaundice, ascites and fatigue [2]. White blood cell count, international normalized ratio, neutrophil count and total serum bilirubin levels are typically abnormal.…”

Section: Introductionmentioning

confidence: 99%

Severe acute alcoholic hepatitis and liver transplant: A never-ending mournful story

et al. 2018

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Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called “6-month rule.” This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.

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Vascular Disorders of the Liver

Cited by 19 publications

References 29 publications

Isolated Hepatic Artery Thrombosis Leading to Multiple Liver Infarcts in a Non-transplant Patient

Isolated Hepatic Artery Thrombosis Leading to Multiple Liver Infarcts in a Non-transplant Patient

Non-alcoholic fatty liver disease, to struggle with the strangle: Oxygen availability in fatty livers

Severe acute alcoholic hepatitis and liver transplant: A never-ending mournful story

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