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World J Gastroenterol. Dec 28, 2010; 16(48): 6046-6057
Published online Dec 28, 2010. doi: 10.3748/wjg.v16.i48.6046
Regulation of hepatic blood flow: The hepatic arterial buffer response revisited
Christian Eipel, Kerstin Abshagen, Brigitte Vollmar
Christian Eipel, Kerstin Abshagen, Brigitte Vollmar, Institute for Experimental Surgery, Medical Faculty, University of Rostock, 18055 Rostock, Germany
Author contributions: Eipel C and Abshagen K performed the research; Vollmar B wrote the paper.
Correspondence to: Brigitte Vollmar, MD, Institute for Experimental Surgery, Medical Faculty, University of Rostock, Schillingallee 69a, 18055 Rostock, Germany. brigitte.vollmar@med.uni-rostock.de
Telephone: +49-381-4942500 Fax: +49-381-4942502
Received: June 28, 2010
Revised: August 26, 2010
Accepted: September 2, 2010
Published online: December 28, 2010
Abstract

The interest in the liver dates back to ancient times when it was considered to be the seat of life processes. The liver is indeed essential to life, not only due to its complex functions in biosynthesis, metabolism and clearance, but also its dramatic role as the blood volume reservoir. Among parenchymal organs, blood flow to the liver is unique due to the dual supply from the portal vein and the hepatic artery. Knowledge of the mutual communication of both the hepatic artery and the portal vein is essential to understand hepatic physiology and pathophysiology. To distinguish the individual importance of each of these inflows in normal and abnormal states is still a challenging task and the subject of ongoing research. A central mechanism that controls and allows constancy of hepatic blood flow is the hepatic arterial buffer response. The current paper reviews the relevance of this intimate hepatic blood flow regulatory system in health and disease. We exclusively focus on the endogenous interrelationship between the hepatic arterial and portal venous inflow circuits in liver resection and transplantation, as well as inflammatory and chronic liver diseases. We do not consider the hepatic microvascular anatomy, as this has been the subject of another recent review.

Keywords: Hepatic blood flow; Hepatic arterial buffer response; Liver