[Quantitative changes of portal and arterial blood supply of the liver following porta-systemic shunting procedures (author's transl)].

Abstract

Hepatic hemodynamic alterations following various porta-systemic shunting procedures were evaluated in the normal and cirrhotic rat liver using a microsphere embolization method. The aim of the study was to differentiate the hepatic arterial and portal venous contribution in a defined cirrhotic rat liver model following total shunting procedures and to determine residual portal blood supply after selective shunt procedures intended to prevent post shunt liver failure. Experimentally selective shunt procedures such as mesentericocaval shunt, splenocaval shunt, portacaval transposition and even portacaval side/side shunting lead to improved hepatic blood supply compared with total end/side shunting. Improvement of liver blood supply is caused rather by arterial compensation than by residual portal blood perfusion. The amount of portal blood supply is not related to a specific type of selective shunt. Evaluation of hepatic arterial compensatory capacity is a more reliable method of predicting total liver blood supply following any shunt procedure.