Vascular changes in the cirrhotic liver as studied by the injection technic

Summary The hepatic vasculature was studied in 9 normal livers, 1 fatty liver, 7 livers with portal cirrhosis, and 3 with postnecrotic cirrhosis (one each of the granular, coarsely nodular, and lobar type). Injection-corrosion cast and latex-injection technics were employed to determine the gross alterations in the vascular architecture, the anatomical evidence for the existence of intrahepatic shunts, the degree of venous compression by regenerative nodules, and the source of the blood supply to the regenerative nodules.An increased prominence of the hepatic arterial system and a reduction in the size of the portal venous bed were observed in both portal and postnecrotic cirrhosis. Vascular distortion was more pronounced in coarsely nodular postnecrotic cirrhosis than in portal cirrhosis. Only scanty and unconvincing evidence of intrahepatic vascular communications was found and the occurrence of physiologically significant shunts in the specimens studied is doubtful.Compression of the smaller and, to a lesser degree, the larger portal and hepatic venous branches was a regular accompaniment of both types of cirrhosis.In all cirrhotic livers, the vascular elements were confined almost entirely to the fibrous septa and the regenerative nodules were poorly supplied by either afferent system. The findings would indicate that the blood supply to the regenerative nodule comes from both the portal vein and the hepatic artery. In contrast to the normal, however, the hepatic artery plays a major role in supplying the parenchyma in both forms of cirrhosis.Supported in part by Contract DA 49-007-MD-592, U. S. Army Medical Research and Development Command, Office of the Surgeon General, Washington, D. C.