The Significance of Small Intestinal Blood as a Hepatotrophic Factor

Naoki Hashimoto, Manabu Nishiwaki, Akihiko Nishioka, Hiroshi Ashida, Yoshinao Kotoura, Joji Utsunomiya

Second Department of Surgery, Hyogo College of Medicine

Diversion of portal blood from the liver results in liver atrophy. Starzl attributes this to the abscence of hepatotrophic factors derived from the pancreas, predominantly insulin. Other investigators maintain that intestinal venous blood serves as the most important source of hepatotrophic factors. Portal blood consists of that of the mesenteric and splenic veins. In order to determine which one of these two is the more important factor in maintaining the liver, we created the canine models of a splenocaval shunt and a partial mesocaval shunt, diverting the small bowell venous outflow into the systemic circulation but leaving the gastric, duodenal, pancreatic and colonic venous outflow undisturbed. We compared the metabolic changes of the two shunt. There was no difference among splenocaval shunt, partial mesocaval shunt and control dogs in amino acids, ammonia and conventional liver function. In hepatic ATP reflecting hepatic mitochondrial function, splenocaval shunt dogs had values similar to those in control dogs. On the other hand, partial mesocaval shunt dogs showed values lower than those of control dogs. These data suggest that venous effluent from the small intestine may be more important in maintaining normal liver function.

Key words
hepatotrophic factors, hepatic ATP, partial mesocaval shunt, splenocaval shunt, Eck fistula

Reprint requests
Naoki Hashimoto Second Department of Surgery, Hyogo College of Medicine
1-1 Mukogawacho, Nishinomiya, 663 JAPAN

Accepted
September 9, 1992

To read the PDF file you will need Abobe Reader installed on your computer.