[New aspects of liver circulation: effects and consequences for the portocaval shunt therapy in liver cirrhosis]

Abstract

Hepatic circulation, which is of essential importance in supplying the liver cells with oxygen and substrates needed for securing metabolic homeostasis of the organism, is characterized by well-regulated mechanisms of intrahepatic arterial, portal and hepatovenous interaction. Furthermore, the hepatic circulation is integrated in the systemic and splanchnic hemodynamic as interposed in a high, or respectively low, pressure system. Beside these hemodynamic mechanisms there are also specific morphologic features in the hepatic vascular bed responsible for regulating liver blood flow. For hepatic nutritions and trophics, and for the metabolic homeostasis of the organism, portal blood is of greater importance than arterial. In porto-caval shunt surgery it is recommended that any remaining portal flow to the liver be preserved to the greatest extent possible.