Changes in blood flow and function of the liver after right portal vein embolization.
OBJECTIVE
Abrupt occlusion of hemihepatic portal vein induced by preoperative portal vein embolization (PVE) may result in drastic alterations in blood flow and functional mass of the liver.


METHODS
Prospective study investigating the outcome of an intervention (PVE).


METHODS
University tertiary-care referral center.


METHODS
Thirteen patients who underwent PVE before extended right hepatectomy.


METHODS
The functional plasma flow and functional mass of the liver as well as the volumes of the left and right lobes were assessed before and after PVE. The functional plasma flow and functional mass of the liver were estimated by measuring the hepatic clearances of sorbitol (a high-extraction drug) and antipyrine (a low-extraction drug), respectively. The liver lobar volumes were measured by computed tomography.


RESULTS
Hepatic plasma clearance of sorbitol (mean +/- SD; before PVE, 632.9 +/- 142.9 mL/min; day 14, 620.2 +/- 138.3 mL/min; not significant by 1-way repeated analysis of variance) and that of antipyrine (before PVE, 27.3 +/- 12.0 mL/min; day 14, 27.9 +/- 13.6 mL/min; P =.85, by paired t test) were stable after PVE. Fourteen days after PVE, the non-PVE-treated lobe was enlarged (mean +/- SD, 137% +/- 30%) and the PVE-treated lobe was atrophic (mean +/- SD, 87% +/- 15%); however, the total liver volume did not change significantly.


CONCLUSIONS
The functional mass and plasma flow of the entire liver were stable after PVE despite the drastic change in the lobar distribution of the portal blood flow, whereas the non-PVE-treated lobe increased significantly in size. Our findings suggest that PVE leads to an increase in both the volume and the functional capacity of the non-PVE-treated lobe.
Shimada
Ryo
R
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Imamura
Hiroshi
H
Nakayama
Ataru
A
Miyagawa
Shinichi
S
Kawasaki
Seiji
S
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics*; D000983:Antipyrine / Q000493:pharmacokinetics*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000493:pharmacokinetics; D008099:Liver / Q000098:blood supply* / Q000378:metabolism*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012039:Regional Blood Flow; D013012:Sorbitol / Q000493:pharmacokinetics*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007202:Indicators and Reagents; D013012:Sorbitol; D000983:Antipyrine