Hepatic circulation : physiology and pathophysiology /

Hepatic circulation : physiology and pathophysiology /

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Bibliographic Details
Author / Creator:Lautt, W. Wayne.
Imprint:San Rafael, Calif. (1537 Fourth Street, San Rafael, CA 94901 USA) : Morgan & Claypool, c2010.
Description:1 electronic text (xiii, 174a p. : ill.) : digital file.
Language:English
Series:Colloquium series on integrated systems physiology, from molecule to function, 1947-9468 ; # 1
Colloquium series on integrated systems physiology, from molecule to function, # 1.
Subject:
Liver -- Blood-vessels.
Hepatic artery.
Liver Circulation.
Hepatic Artery.
Liver -- Blood-vessels.
Liver -- Pathophysiology.
Liver -- Physiology.
Liver -- Regeneration.
Format: E-Resource Book
URL for this record:http://pi.lib.uchicago.edu/1001/cat/bib/8512926
Hidden Bibliographic Details
ISBN:9781615040100 (electronic bk.)
9781615040094 (pbk.)
Notes:Title from PDF t.p. (viewed on March 16, 2010).
Series from website.
Includes bibliographical references (p. 149-174a).
Abstract freely available; full-text restricted to subscribers or individual document purchasers.
Mode of access: World Wide Web.
System requirements: Adobe Acrobat reader.
Summary:The Hepatic circulation is unique among vascular beds. The most obvious unique features include the dual vascular supply; the mechanism of intrinsic regulation of the hepatic artery (the hepatic arterial buffer response); the fact that portal blood flow, supplying two thirds of liver blood flow, is not controlled directly by the liver; the fact that 20% of the cardiac output rushes through the most vascularized organ in the body, driven by a pressure gradient of only a few millimeters of mercury; the extremely distensible capacitance and venous resistance sites; the unidirectional acinar blood flow that regulates parenchymal cell metabolic specialization; and the high concentration of macrophagic (Kupffer) cells filtering the blood. The liver is the only organ reported to have regional blood flow monitored by the autonomic nervous system. This mechanism, when dysfunctional, accounts for the hepatorenal syndrome and offers a mechanistic therapeutic target to treat this syndrome. The trigger for liver regeneration is dependent on hepatic hemodynamics so that chronic liver blood flow regulates liver cell mass. In severe liver disease, the whole body circulation is reorganized, by forming portacaval shunts, to accommodate the increased intrahepatic venous resistance. These shunts protect the venous drainage of the splanchnic organs but lead to loss of major regulatory roles of the liver. The development of knowledge of the hepatic vasculature is presented from a historical perspective with modern concepts summarized based on the perspective of the author's four decades of devotion to this most marvelous of organs.
Standard no.:10.4199/C00004ED1V01Y200910ISP001
Table of Contents:
  • 1. Historical perspectives
  • 2. Overview
  • Microcirculation
  • Hepatic microvascular zones
  • Intrahepatic flow distribution
  • Kupffer cells
  • Stellate cells
  • Sinusoidal endothelial cells
  • The space of mall
  • 3. Fluid exchange
  • Flow-limited distribution of blood-borne substances
  • Ascites formation
  • Effects of drugs on fluid exchange
  • Effects of hepatic nerve stimulation
  • Blood flow and hepatic clearance of drugs and hormones
  • 4. Capacitance
  • Hepatic blood volume
  • Capacitance functions in diseased livers
  • 5. Resistance in the hepatic artery
  • Intrinsic blood flow regulation: the hepatic arterial buffer response and autoregulation
  • Metabolism and hepatic blood flow
  • Portal flow regulation of hepatic arterial flow
  • Autoregulation
  • Quantitative aspects of the HABR
  • Roles of the HABR
  • Clinical relevance
  • Unresolved issues
  • Extrinsic influences
  • Caffeine
  • Vasodilators
  • Carbon monoxide
  • Hydrogen sulfide
  • 6. Resistance in the venous system
  • Essential assumptions
  • Passive distensibility
  • 7. Fetal and neonatal hepatic circulation
  • 8. In vivo pharmacodynamic approaches
  • Resistance or conductance
  • Index of contractility
  • Surgical preparation considerations
  • Effect of vasoactive drugs on the hepatic artery when administered intravenously
  • 9. Nitric oxide
  • Shear stress
  • 10. Adenosine
  • 11. Hepatic nerves
  • Extrinsic nerve supply
  • Intrinsic nerves
  • Developmental aspects
  • Vascular responses
  • The hepatic artery
  • Basal tone
  • Reflex activation
  • Neurovascular approach in vivo
  • Blood flow distribution
  • Venous resistance vessel responses to sympathetic nerve stimulation
  • Presinusoidal or portal responses
  • Hepatic venous resistance responses
  • Hepatic blood volume
  • Stressed and unstressed volume
  • Responses to direct nerve stimulation
  • Reflex control of hepatic capacitance
  • Hepatic fluid exchange
  • Noradrenaline overflow
  • Neurotransmitters and neuromodulation
  • Disease states
  • Technical considerations (avoid the sucker punch)
  • 12. Hepatic circulation and toxicology
  • Hepatic blood flow
  • Veno-occlusive toxins
  • Heterogeneity of perfusion
  • Capillarization
  • Ethanol
  • Methodological considerations
  • Free radicals and antioxidants
  • Samec
  • 13. Hepatorenal syndrome
  • 14. Integrative hepatic response to hemorrhage
  • 15. Blood flow regulation of hepatocyte proliferation
  • 16. Multiple mechanisms maintaining a constant hepatic blood flow to liver mass ratio
  • Overview
  • Hepatic compliance
  • The HABR
  • The hepatorenal reflex
  • Modulation of vasoconstrictors by adenosine and nitric oxide
  • Blood flow regulation of hepatocyte proliferation
  • 17. Pathopharmacology and repurposing drugs as a research strategy
  • The pathology, the hepatorenal syndrome
  • References.

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