From the Guidelines
The liver receives its blood supply from both the hepatic artery and the portal vein, with the majority coming from the portal vein. This dual blood supply is crucial for the liver's functions, including metabolism, detoxification, and protein synthesis. According to a recent study published in 2021 1, the surrounding liver tissue receives its blood supply from both the portal vein and the hepatic artery, whereas hepatocellular carcinoma (HCC) lesions derive most of their blood supply from the hepatic artery.
Key Points About Liver Blood Supply
- The liver's unique dual blood supply system ensures it receives both nutrients and oxygen
- The portal vein provides approximately 75% of the liver's blood supply, carrying nutrient-rich, deoxygenated blood from the digestive organs and spleen
- The hepatic artery delivers the remaining 25% of the liver's blood supply, providing oxygenated blood directly from the heart
- This dual supply supports the liver's critical roles in metabolism, detoxification, protein synthesis, and bile production, as noted in the context of hepatobiliary cancers 1
Clinical Implications
- Understanding the liver's blood supply is essential for diagnosing and managing liver diseases, such as HCC and cirrhosis
- Compromised blood flow due to portal hypertension or cirrhosis can lead to various complications, including varices and ascites
- Diagnostic imaging techniques, such as multiphasic liver protocol CT and MRI, can help characterize the liver's blood supply and detect HCC lesions, which are typically characterized by arterial hypervascularity and "wash out" on portal venous phases 1
From the Research
Liver Blood Supply
The liver receives its blood supply from two main sources:
- The hepatic artery, which provides oxygenated blood
- The portal vein, which carries deoxygenated blood from the digestive organs
Portal Hypertension
Portal hypertension, defined as increased pressure in the portal vein, can affect the liver blood supply 2. This condition develops as a consequence of increased intrahepatic vascular resistance due to the dysregulation of:
- Liver sinusoidal endothelial cells (LSECs)
- Hepatic stellate cells (HSCs) Extrahepatic haemodynamic changes can also contribute to the aggravation of portal hypertension 2.
Mechanisms of Portal Hypertension
The pathogenic complexity of portal hypertension involves:
- Cellular and molecular mechanisms, including dysregulation of LSECs, HSCs, and hepatic microvascular thrombosis
- Changes in the extrahepatic vasculature, which are major contributors to portal hypertension 2