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Hepatic Circulation (Paperback, New)
Loot Price: R1,375
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Hepatic Circulation (Paperback, New)
Series: Colloquium Series on Integrated Systems Physiology
Expected to ship within 10 - 15 working days
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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. Table of Contents: Acknowledgements /
Historical Perspectives / Overview / Fluid Exchange / Capacitance /
Resistance in the Hepatic Artery / Resistance in the Venous System
/ Fetal and Neonatal Hepatic Circulation / In Vivo Pharmacodynamic
Approaches / Nitric Oxide / Adenosine / Hepatic Nerves / Hepatic
Circulation and Toxicology / Hepatorenal Syndrome / Integrative
Hepatic Response to Hemorrhage / Blood Flow Regulation of
Hepatocyte Proliferation / Multiple Mechanisms Maintaining a
Constant Hepatic Blood Flow to Liver Mass Ratio / Pathopharmacology
and Repurposing Drugs as a Research Strategy / References
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