Regulation of hepatic blood flow: The hepatic arterial buffer response revisited

Figure 1 Hepatic hemodynamics in normal and reduced-size livers. A: Preoperative hepatic blood flow in a donor liver or before extended hepatectomy representing a normal portal vein blood flow-hepatic artery blood flow (PVBF/HABF) ratio of 2.5; B: As a consequence of portal hyperperfusion, hepatic arterial buffer response (HABR) leads to hepatic arterial hypoperfusion of reduced-size liver that is characterized by a dramatically increased PVBF/HABF ratio of 29; C: Surgical reduction of the portal venous inflow, for example, by splenectomy or hepatic artery ligation, leads to HABR-induced dilation of the hepatic artery and results in a reduced PVBF/HABF ratio of 22; D: Possible effects of pharmacological interventions to preserve hepatic artery supply. PVBF/HABF ratios are adopted from[59]. HA: Hepatic artery; IVC: Inferior vena cava; PV: Portal vein.

Figure 2 Surgical interventions for modulation of the hepatic inflow, showing the portocaval shunt (short arrow), ligation of the splenic artery (thin long arrow) and splenectomy (thick long arrow). BD: Bile duct; HA: Hepatic artery; IVC: Inferior vena cava; PV: Portal vein; SpA: Splenic artery.