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0:00
Hello, my name is
Clara Tow and I am
a transplant hepatologist at
the Montefiore Medical Center,
Albert Einstein College of
Medicine in New York City.
It gives me great
pleasure to talk to you
today about portal
hypertension at the bedside.
0:18
In this talk, we
will be reviewing
many aspects of
portal hypertension.
I think it's important to
understand the anatomy of
the portal circulation
and talk about what is
normal before we define
what is abnormal.
We will discuss how portal
hypertension develops,
the different complications
that can occur and end on
a discussion about
the best treatments
we have for this
disease process.
0:42
The liver is a very
complex organ,
if I had to summarize it,
I would say that it was a
metabolically active filter.
Because it is this filter,
blood flow through
it is really key.
It's all about how
the blood interacts
with the liver and
the individual cells,
and how that blood flow
allows the liver to
do all the activities
it's supposed to do.
1:05
The liver is a very
unique organ because it
has a dual vascular supply.
It has a hepatic
artery that delivers
highly oxygenated
blood to this organ.
This is a very classic
arterial system.
The liver also has
a portal vein,
which delivers partially
oxygenated blood to the liver.
It is responsible for
about 20% of the total
oxygen delivery.
The blood from the
portal vein is derived
from draining veins throughout
the GI tract and spleen,
and they eventually converge
to form the portal vein.
As the blood moves
through the liver,
it goes through smaller and
smaller channels until we get to
the most microscopic
level where blood
is literally flowing between
sheets of hepatocytes.
Then they begin to converge
into the outflow track,
which is what we call
the hepatic vein.
The veins draining from the
GI tract and the spleen,
the portal vein, the
flow of blood through
the liver and eventually
leaving the liver through
the hepatic vein.
This is what we call
portal circulation.
