Tolerance of the liver as measured by ketone body ratio and hepatocyte energy charge to 120 minutes acute venous congestion in dogs.

Although acute passive hepatic congestion (APHC) sometimes occurs in patients undergoing open heart surgery or liver transplantation, the effects and safety limits of APHC on hepatic energy status have yet to be investigated. The present study reports an APHC model in 11 dogs in comparison with a control in 9 dogs by clamping the throacic inferior vena cava with passive venovenous shunt (APHC group) and by clamping the same with an active shunt at a rate of 60 ml/min/kg (control group). We investigated the effects of 120-min APHC on hepatic energy status by assessing the changes in arterial ketone body ratio (KBR) and hepatic energy charge (EC). After induction of the APHC, portal vein pressure elevated significantly to almost three times the control level. KBR decreased significantly for 60 min as compared with that of the control, but gradually recovered thereafter, returning to the preclamping level after reversal. Although total hepatic blood flow after 60-min clamping was approximately 18% of the preclamping value, no significant differences in EC and KBR values were seen after 60-min clamping as compared with preclamping and the control. All dogs in both groups survived at least 1 week. In this experimental model, 120-min APHC had no long-term effects on hemodynamics and energy production in the liver.