There is considerable evidence that impairment of hepatic function occurs when the hepatic blood flow is reduced. Whipple1 and Knutti2 have shown that production of hemoglobin and serum proteins in animals with an Eck fistula is below normal. Harper et al.3 have found decreased tolerance to orally administered amino acids in dogs with Eck fistulas. Several authors have found clinical evidence of progressive deterioration of hepatic function following surgically constructed portacaval shunts.4,5 Reduction of hepatic blood flow has also resulted in impairment of regeneration of liver tissue. Mann and Magath6 have shown that there is an almost complete disappearance of the regenerative capacity of the liver following the production of an Eck fistula. On the other hand, the liver will regenerate very well when a portacaval transposition has been carried out, indicating that portal blood per se is unnecessary for regeneration of the liver.7
SILEN W, MAWDSLEY DL, WEIRICH WL, HARPER HA. Studies of Hepatic Function in Dogs with Eck Fistula or Portacaval Transposition. AMA Arch Surg. 1957;74(6):964–973. doi:10.1001/archsurg.1957.01280120142017
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