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Portal flow augmentation for liver cirrhosis
L R Jiao1, A M Seifalian, R T Mathie
1Liver Surgery Unit, Imperial College School of Medicine, Hammersmith Hospital and University Department of Surgery, Royal Free and University College Medical School, University College London, London, UK.
The British Journal of Surgery
|August 10, 2000
Summary
Mechanically pumping portal venous inflow can reduce portal hypertension and intrahepatic portal vascular resistance in cirrhosis. Further research is needed to assess its impact on liver function before clinical use.
Area of Science:
- Hepatology
- Vascular Surgery
- Gastroenterology
Background:
- Portal hypertension from chronic liver disease is a leading cause of mortality.
- Liver transplantation is the optimal treatment but inaccessible to most patients.
- Augmented portal perfusion is a novel approach to manage portal hypertension.
Purpose of the Study:
- To evaluate the efficacy of augmented portal perfusion in managing portal hypertension.
- To analyze hemodynamic changes associated with increased portal venous inflow.
Main Methods:
- Systematic review and meta-analysis of published studies on augmented portal perfusion.
- Searched Medline and other databases for relevant research.
- Calculated changes in intrahepatic portal vascular resistance (IHPR) from portal pressure and blood flow data.
Main Results:
- Meta-analysis of seven studies showed increased portal venous inflow significantly reduced mesenteric portal pressure and IHPR.
- A significant rise in hepatic portal venous pressure was observed (P < 0.001).
- Limited data exist on the impact of augmented portal perfusion on liver function.
Conclusions:
- Augmented portal perfusion demonstrates potential in reducing portal hypertension and IHPR.
- Further in vivo studies are necessary to evaluate hemodynamic and functional changes in cirrhotic livers.
- Clinical application requires more detailed experimental validation.