THE ESTIMATION OF HEPATIC BLOOD FLOW AND INTRAHEPATIC SHUNTED BLOOD FLOW BY COLLOIDAL HEAT-DENATURED HUMAN SERUM ALBUMIN LABELED WITH I131

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Abstract
The colloidal albumin I131 (CAI131) method for measuring liver blood flow was investigated in normal subjects and patients with liver disease. In normal subjects the method is valid without hepatic vein catheterization, since the hepatic extraction of the colloid averaged 94% in one passage through the liver. In patients with cirrhosis the hepatic extraction of the colloid averaged 75.8% when the portal vein was patent, but rose to 89.6% when the portal vein was disconnected from the liver by a portacaval anastomosis. The reduced hepatic extraction of CAI131 in patients with cirrhosis probably is due to intra-hepatic shunting of colloid which bypasses Kupffer cells in "internal Eck fistulae". Hepatie vein catheterization permits an estimate of this shunting. Total hepatic blood flow may be calculated from the peripheral colloid blood flow (minimal hepatic blood flow) corrected for hepatic extraction. Total hepatic blood flow measured by colloid albumin correlated well with hepatic blood flow measured with indocyanine green. Minimal hepatic flow results (uncorrected for hepatic extraction) may be used as an index of hepatic sinusoidal blood flow and as a measure of the functional blood supply to the cirrhotic liver.

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