Study on State of Hepatic Circulation Part 2. Determination of Hepatic Blood Flow Volume by Application of BSP and Galactose Clearance, Particularly, Review from the Viewpoint of BSP Metabolism

The Calactose Continual Infusion Method devised by Nakamura et al and the BSP Continual Infusion Method reported by Bradley et al were used simultaneously on 21 chronic hepatitis and 9 hepatocirrhosis patients, and the hepatic blood flow volume was determined. The results obtained are as follows. 1) The total hepatic blood flow volume as determined by both methods were in agreement in cases with comparatively mild hepatic disturbance, but in such cases as hepatocirrhosis where abvanced cellular degeneration and necrosis were present, the value as determined by BSP method was greater than that obtained by the Galactose method. This is felt to be due to BSP clearance, particularly, the close relationship with the hepatic cell uptake capacity of BSP. 2) There is a definite difference in galactose and BSP elimination rates. The 15 cases that demonstrated a 100% elimination of galactose had BSP elimination rates which ranged from 33.0 to 84.6%, thus, in all cases the rates for the latter were lower. From these reslts, even though the BSP method may indicate a normal liver, it is felt that, there may be a hepatic shunt blood flow volume, but this is presumed to be due to the fact that the BSP up take capacity of hepatic cells is not 100% or it may be that although they have such uptake capacity, the BSP which has been taken up is again released into the blood. 3) With the use of dogs BSP in amounts less than the Maximum elimination volume of the liver was administered in succession into the peripheral vein, hepatic vein and portal vein by continual infusion, and the BSP concentration in hepatic venous blood was determined. Results showed that both the portal and hepatic venous areas were involved in the hepatic eimination of BSP. 4) Therefore, it is felt inappropriate to use BSP to determine hepatic blood flow volume in cases with hepatic disturbances