Blood Supply and Oxygenation Status of the Liver: From Physiology to Malignancy.

Abstract

To maintain a multitude of vital functions, blood flow to the normal liver and the hepatic oxygenation status has to be kept on a high level (1.0-1.2mL/g/min and 30-40mmHg, respectively). There is a longitudinal oxygen partial pressure (pO2) gradient within the liver sinusoids between periportal inflow and outflow into the central vein leading to a zonation of the O2 status, which is associated with a zoning of liver functions. Oxygenation of metastatic lesions of colorectal cancers in the liver is poor due to a dysfunctional vascularity and inadequate blood supply. Hepatocellular carcinomas (HCCs) are highly vascularised (arterialised), metabolically very active and present with a predominantly arterial blood supply. HCCs are generally believed to be very hypoxic. However,confirmation of severe hypoxia based on reliable, direct pO2 measurements in HCCs is still missing.