Portal Hypertension: New Insights

Gerond V. Lake-Bakaar (Editor)
Transplant Center, Porter Adventist Hospital, Denver, CO, USA

Series: Hepatology Research and Clinical Developments
BISAC: MED114000

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The cirrhotic liver is significantly more vulnerable to injury. This vulnerability is particularly evident after the advent of portal hypertension. In the normal liver, up to 75 percent can be resected without decompensation. By contrast, in the cirrhotic liver with portal hypertension, liver decompensation can occur even after less than 50 percent of the liver is resected.

This book, “Portal Hypertension: New Insights” begins with an attempt to provide insights into this unanswered puzzle. The normal liver is soft and elastic. By contrast, the cirrhotic liver is inelastic and rigid. Flow in rigid tubes is governed by the Hagen-Poiseuille law. The law dictates that pressure gradient increases exponentially by the fourth power of the radius of the rigid sinusoid. This makes the cirrhotic liver virtually incapable of accommodating any increase in flow. The increase in pressure gradient is equivalent to the fourth power of the vessel radius.

The first chapter explores the major new insight that decompensation in the cirrhotic liver is related to the loss of elasticity and the development of vessel wall rigidity, which thereafter subjects flow in the hepatic sinusoids to the Hagen-Poiseuille law.
The rest of the book addresses portal hypertension in its clinical context. It invites the reader to survey multiple avenues associated with portal hypertension, including idiopathic non-cirrhotic portal hypertension, INCPH and non-alcoholic fatty liver disease, NAFLD. It also includes chapters on relationships between portal hypertension, the gastrointestinal system and the renal system. In general, the book provides several new insights into portal hypertension. (Imprint: Nova Biomedical)

Chapter 1. Portal Hypertension in Liver Cirrhosis as a Consequence of Sinusoidal Wall Rigidity and Hagen-Poisseuille’s Law
Gerond Lake-Bakaar, MD, PhD (Liver Center, Beth Israel Deaconess Medical Center, Boston, MA, USA)

Chapter 2. Hepatic Steatosis and Portal Hypertension
Denise van der Graaff, MD, Wilhelmus J. Kwanten, MD and Sven M. Francque, MD, PhD (Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem (Antwerp), Belgium, and others)

Chapter 3. Unusual Manifestations of Portal Hypertension
Lisa A. Miller, MD, David G. Schutter, MD, and Leandra H. Burke (Department of General Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA)

Chapter 4. Portal Hypertension and the Kidneys
Philippe Gauthier, MD (Transplant Center, Porter Adventist Hospital, Denver, CO, USA)

Chapter 5. Gastrointestinal Manifestations of Portal Hypertension
Aliya G. Hasan, MD (Digestive Health, Porter Adventist Hospital, Denver, Colorado, USA)

Chapter 6. Idiopathic Non-Cirrhotic Portal Hypertension
Maryann Huang, MD (Transplant Center, Porter Adventist Hospital, Denver, Colorado, USA)

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