Hepatic blood volume is decreased in patients with cirrhosis and does not decrease further after a meal like in healthy persons

Abstract

Background & Aims The aim was to measure fractional hepatic blood volume (HBV) and hepatic blood flow (HBF) before and after a meal in patients with cirrhosis (n = 7) and healthy persons (n = 6). Methods Catheters were placed in a radial artery and a hepatic vein for blood sampling and a peripheral vein for indocyanine green (ICG) infusion. A 6-min positron emission tomography (PET) liver scan was performed after inhalation of 1000 MBq 15O-CO and repeated after ingestion of a standard meal. HBV was calculated as the 15O-CO concentration in liver tissue (PET) divided by that in arterial blood. HBF was calculated from ICG infusion rate and arterial and hepatic venous blood concentrations according to Fick’s principle. Results Mean fasting HBV was 14 mL blood/100 mL liver tissue in patients with cirrhosis and 21 mL blood/100 mL liver tissue in healthy subjects (p < .01). Mean HBV did not change postprandially in patients with cirrhosis (13 mL blood/100 mL liver tissue) but decreased in healthy subjects (17 mL blood/100 mL liver tissue; p = .02). Mean fasting HBF was 1.5 L blood/min in patients with cirrhosis and 1.1 L blood/min in healthy subjects and increased in both groups of subjects to 1.8 L blood/min. Conclusions Fasting HBV was lower in patients with cirrhosis and did not decrease postprandially as it did in the healthy controls although the HBF increased equally. Patients with cirrhosis thus have a disturbed hemodynamic response to normo-physiological changes such as a meal.