HEMODYNAMICS AND HEPATIC ENERGY-METABOLISM IN CANINE MODEL OF ACUTE HEPATIC VENOUS OCCLUSION WITH MESOCAVAL SHUNT

The relationship between portal hemodynamics and the energy metabolism of the liver with acute hepatic venous occlusion (HVO) was investigat ed by assessing the changes in the hepatic blood flow, arterial blood ketone body ratio (AKBR) and adenylate energy charge potential (ECP) o f the liver tissue in canine model. Acute HVO was induced by the ligat ion of both the supra- and infrahepatic inferior vena cava (IVC) over the protruding ends of a heparin-coated polyethylene cannula inserted into the IVC. All dogs with only HVO (n = 5) died within 30 min. HVO d ogs with additional mesocaval (MC) shunt (n = 10) survived longer than 7 days, during which time their AKBR were maintained in the normal ra nge (over 1.0). ECP was also maintained above the normal level (over 0 .850) during the 28-day period. Along with increasing portal pressure caused by the narrowing of the shunt anastomosis, the hepatic blood fl ow decrease gradually, resulting in a sudden decrease in AKBR and ECP when the portal pressure increased over 11 mm Hg. It is suggested that the normalization of portal pressure is one of the most important fac tors for maintaining the hepatic energy metabolism and that MC shunt i s an effective therapy for maintaining the function of the liver with HVO, as long as portal pressure can be kept within normal range.