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The Role of Arterial, Portal, and Systemic Venous Blood

Marvin Wexler, MD; Maurice Slapak, M Chir, FRCS (C, Eng); Ryuji Mizumoto, MD; Alexandro Latzina, MD; Geoffrey Giles, MD, FRCS; Enrique Soto, MD; William V. McDermott, Jr., MD

AMA Arch Surg. 1970;101(2):267-276.

Abstract
Regeneration, function, and maintenance of integrity were studied in five groups of hemihepatectomized dogs with varying hemodynamic inflow and one group with intact livers but differentially ligated inflow to each half. Regeneration was similar in dogs with both hepatic arterial and portal venous supply, compared with those with portal vein supply only, but was minimal in livers supplied by artery only. This was not increased with perineurectomy. Augmentation of flow in this latter group, utilizing a portarenal transposition, resulted in significant increase in liver mass and size on scan and a healthier course. Atrophy, as distinct from lack of regeneration, is solely dependent upon adequacy of total liver blood flow and not any trophic substance or type of flow. This concept is extended to the auxiliary transplant model and its possible use as temporary hepatic support.

Author Affiliations
Montreal; Boston

From the Sears Surgical Laboratory, Boston City Hospital, and Department of Surgery, Harvard Medical School, Boston (Drs. Slapak, Mizumoto, Latzina, Giles, and McDermott); Mallory Institute of Pathology, Boston City Hospital, Boston (Dr. Soto); and the Department of Experimental Surgery, Royal Victoria Hospital, McGill University, Montreal (Dr. Wexler).

Footnotes
Accepted for publication April 15, 1970.

Read before the 27th annual meeting of the Central Surgical Association, Detroit, Feb 27, 1970.

Reprint requests to Department of Surgery, Royal Victoria Hospital, McGill University, Montreal (Dr. Wexler).

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