Hepatic circulation : physiology and pathophysiology / W. Wayne Lautt.

Format:

Book

Author/Creator:

Lautt, W. Wayne.

Series:

Colloquium series on integrated systems physiology ; #1.

Colloquium series on integrated systems physiology : from molecule to function to disease ; bk. #1

Language:

English

Subjects (All):

Liver--Blood-vessels.

Liver.

Physical Description:

1 online resource (190 p.)

Place of Publication:

[San Rafael, Calif.?] : Morgan & Claypool Life Sciences, 2010.

Language Note:

English

Summary:

The Hepatic circulation is unique among vascular beds. The most obvious unique features include the dual vascular supply; the mechanism of intrinsic regulation of the hepatic artery (the hepatic arterial buffer response); the fact that portal blood flow, supplying two thirds of liver blood flow, is not controlled directly by the liver; the fact that 20% of the cardiac output rushes through the most vascularized organ in the body, driven by a pressure gradient of only a few millimeters of mercury; the extremely distensible capacitance and venous resistance sites; the unidirectional acinar blood flow that regulates parenchymal cell metabolic specialization; and the high concentration of macrophagic (Kupffer) cells filtering the blood. The liver is the only organ reported to have regional blood flow monitored by the autonomic nervous system. This mechanism, when dysfunctional, accounts for the hepatorenal syndrome and offers a mechanistic therapeutic target to treat this syndrome. The trigger for liver regeneration is dependent on hepatic hemodynamics so that chronic liver blood flow regulates liver cell mass. In severe liver disease, the whole body circulation is reorganized, by forming portacaval shunts, to accommodate the increased intrahepatic venous resistance. These shunts protect the venous drainage of the splanchnic organs but lead to loss of major regulatory roles of the liver. The development of knowledge of the hepatic vasculature is presented from a historical perspective with modern concepts summarized based on the perspective of the author's four decades of devotion to this most marvelous of organs.

Contents:

1. Historical perspectives

2. Overview

Microcirculation

Hepatic microvascular zones

Intrahepatic flow distribution

Kupffer cells

Stellate cells

Sinusoidal endothelial cells

The space of mall

3. Fluid exchange

Flow-limited distribution of blood-borne substances

Ascites formation

Effects of drugs on fluid exchange

Effects of hepatic nerve stimulation

Blood flow and hepatic clearance of drugs and hormones

4. Capacitance

Hepatic blood volume

Capacitance functions in diseased livers

5. Resistance in the hepatic artery

Intrinsic blood flow regulation: the hepatic arterial buffer response and autoregulation

Metabolism and hepatic blood flow

Portal flow regulation of hepatic arterial flow

Autoregulation

Quantitative aspects of the HABR

Roles of the HABR

Clinical relevance

Unresolved issues

Extrinsic influences

Caffeine

Vasodilators

Carbon monoxide

Hydrogen sulfide

6. Resistance in the venous system

Essential assumptions

Passive distensibility

7. Fetal and neonatal hepatic circulation

8. In vivo pharmacodynamic approaches

Resistance or conductance

Index of contractility

Surgical preparation considerations

Effect of vasoactive drugs on the hepatic artery when administered intravenously

9. Nitric oxide

Shear stress

10. Adenosine

11. Hepatic nerves

Extrinsic nerve supply

Intrinsic nerves

Developmental aspects

Vascular responses

The hepatic artery

Basal tone

Reflex activation

Neurovascular approach in vivo

Blood flow distribution

Venous resistance vessel responses to sympathetic nerve stimulation

Presinusoidal or portal responses

Hepatic venous resistance responses

Stressed and unstressed volume

Responses to direct nerve stimulation

Reflex control of hepatic capacitance

Hepatic fluid exchange

Noradrenaline overflow

Neurotransmitters and neuromodulation

Disease states

Technical considerations (avoid the sucker punch)

12. Hepatic circulation and toxicology

Hepatic blood flow

Veno-occlusive toxins

Heterogeneity of perfusion

Capillarization

Ethanol

Methodological considerations

Free radicals and antioxidants

Samec

13. Hepatorenal syndrome

14. Integrative hepatic response to hemorrhage

15. Blood flow regulation of hepatocyte proliferation

16. Multiple mechanisms maintaining a constant hepatic blood flow to liver mass ratio

Overview

Hepatic compliance

The HABR

The hepatorenal reflex

Modulation of vasoconstrictors by adenosine and nitric oxide

Blood flow regulation of hepatocyte proliferation

17. Pathopharmacology and repurposing drugs as a research strategy

The pathology, the hepatorenal syndrome

References.

Notes:

Title from PDF t.p. (viewed on March 16, 2010).

Last 3 pages numbered 174, 174a, 174a.

Includes bibliographical references.

Cited in:

Google scholar

Google book search

ISBN:

1-61504-010-2

OCLC:

656435104