Tolerance of the liver to ischemia: an experimental study

The experiments described in this study challenge the 20th century belief that the liver is particularly vulnerable to deprivation of its blood supply for appreciable periods of time. The authors studied the effects of 60 minutes of normothermic hepatic ischemia on 10 pigs. The hepatic artery and its collateral vessels were occluded and portal blood was diverted by a portojugular shunt. This produced a 90% reduction in liver blood flow as determined by xenon-127 washout. None of the animals died of liver failure. The ischemic insult did not produce jaundice in any of the animals and only minimal transient changes in liver enzymes occurred. The results suggest that the liver is capable of withstanding prolonged periods of ischemia.