Increased prevelance of osteoporosis in patients with end-stage liver diseasse secondary to hepatitis C infection and alcohol

Abstract

Background: Decrease in portal flow are known to be partly compensated by the increase in hepatic arterial flow under various pathological conditions. However, it is unclear whether this phenomenon is also observed when the hemihepatic portal flow is interrupted and whether the arterial flow decreases when the portal flow is increased. Methods:Both portal and hepatic arterial blood flow was measured intraoperatively by transit time 2-channel ultrasonic volume tlowmeter innine donorsof living-related liver transplantations. Simultaneous measurements of right hepatic artery (RHA) and left hepatic artery (LHA), right portal vein (RPV) and left portal vein (LPV) were carried out with and without clamping RPV by vascular forceps. Results: Blond flow of RHA was significantly increased when RPV is clamped by 202 % (141.0}.3 ml/min to 257.3}.5 ml/min, respectively; p=O.02). Blood flow of LPV significantly increased when RPV clamping by 316 % (387.9}.8 ml/min to 217.8}.3 ml/min, respectively; p = 0.01). Blood flow of LHA didnt increase significantly when RPV is clamped (116.5}.9 ml/min to 140.0}.9 ml/min, respeetively; p=0.27). Total portal flow significantly decreased by 62 % when RPV clamping (705.0}.6 ml/min to 387.9}.8 ml/min, respectively; p=O.03). Total hepatic arterial flow with and without clamping RPV were not significantly different (373.8}.1 ml/min vs. 281.0}.5 ml/min, respectively; p = 0.09). RPV flow was compensated with the increase of RHA flow by 13 %. With clamping RPV, total hepatic flow of the left hemiliver significantly increased by 162 % (309.4}.3 ml/min to 418.2}.5 ml/min, respectively; p=O.03). Conclusion: Although RPV clamping ensued in the increased LPV flow, total portal flow decreased at least immediately after RPV clamping. Hemihepatic portal venous occlusion resulted in the increase in the arterial flow of the corresponding hemiliver; whereas, in the contralateral hemiliver, the increase in the portal venous flow was not compensated by the decrease in the hepatic arterial flow.