RELATIONSHIP BETWEEN HEPATIC BLOOD-FLOW, LIVER TESTS, HEMODYNAMIC VALUES AND CLINICAL CHARACTERISTICS IN PATIENTS WITH CHRONIC LIVER-DISEASE

Although hepatic blood flow (HBF) has been measured in patients with l iver disease for many years, the results of these studies have not pro vided clear information concerning the usefulness of this measurement. Hepatic blood flow was measured in 392 patients with either cirrhosis (n = 356) or hepatic fibrosis (n = 36). The control group included 59 subjects with normal liver architecture. Hepatic clearance of indocya nine green (ICG) was markedly reduced in patients with cirrhosis and h epatic fibrosis compared with controls (182+/-5, 276+/-22 and 421+/-25 mL/min, respectively). In patients with cirrhosis, ICG clearance and extraction were significantly correlated, but were not correlated to H BE Although HBF did not differ between patients with cirrhosis and con trols (1.26+/-0.04 vs 1.35+/-0.07 L/min, respectively), patients with hepatic fibrosis had lower HBF (1.04+/-0.07 L/min; P<0.05). In patient s with cirrhosis, no correlation was observed between HBF and cardiac output, mean arterial pressure, azygos blood flow, the hepatic venous pressure gradient or Pugh's score. However, a significant difference i n HBF was observed in patients with and without hepatic encephalopathy (1.00+/-0.09 vs 1.28+/-0.03 L/min, respectively; P<0.05). In conclusi on, the present study shows that, in patients with cirrhosis, HBF is n ormal and is nor related to other haemodynamic values or liver tests. These results discourage the measurement of HBF in the evaluation of p atients with cirrhosis.