Hepatic blood flow in alcoholic liver disease measured by an indicator dilution technic

Abstract

Indicator dilution curves recorded from hepatic venous blood after selective injection of I 131 albumin into the hepatic artery were used to calculate hepatic blood flow in four normal subjects and forty-five patients with alcoholic liver disease. In fourteen patients with acute alcoholic hepatitis, hepatic blood flow was significantly higher (average 1,170 ± 94 [SEM] ml/minute/M 2) than in normal subjects (average 669 ± 62 ml/minute/M 2) or in twenty-four patients with chronic alcoholic liver disease (average 870 ± 76 ml/minute/M 2). In seven patients with preterminal hepatic failure hepatic blood flow averaged 982 ± 202 ml/minute/M 2. The hepatic fraction of cardiac output averaged 24.6 per cent in normal subjects and 25.9 per cent in those with alcoholic hepatitis, but it was significantly reduced in patients with chronic liver disease (average 19.3 per cent) and hepatic failure (average 20.1 per cent). Hepatic plasma volume also was higher in patients with alcoholic hepatitis (average 436 ml) than in the normal subjects (average 364 ml), the patients with chronic alcoholic liver disease (average 365 ml) or the patients with hepatic failure (average 336 ml). Despite the normal or high hepatic blood flow in most patients with alcoholic liver disease, abnormally high hepatic venous oxygen saturation was indicative of reduced splanchnic oxygen consumption in patients with alcoholic hepatitis and in those with hepatic failure compared to the normal subjects. A significant correlation between arteriovenous oxygen difference and hepatic albumin mean transit time suggests that intrahepatic shunting of oxygen could be a factor contributing to impaired hepatic function.