Can mechanical augmentation of portal vein flow be an alternative treatment for portal hypertension and liver failure

: In the past few years in vivo and ex vivo experiments using mechanical augmentation of portal inflow have shown a reduction in mesenteric portal venous pressure, intrahepatic portal vascular resistance and an improvement in liver function in cirrhotic animals. The latest technical development has allowed a construction of a miniature portal pump for human implantation. The aim of this study was to assess the short-term effect of mechanically increasing portal blood flow on hepatic haemodynamics and liver function in a cirrhotic porcine model. Liver cirrhosis was established by ligation of common bile duct in pigs. After four weeks, when the animals had become cirrhotic, the miniature pump was placed in the portal vein and blood flow was increased by 50% for one hour. Enhanced portal flow in the cirrhotic animals decreased mesenteric portal pressure, improved liver function and hepatic haemodynamics. However, long-term experiments will be needed to confirm the concept of enhancement of portal inflow as a feasible treatment for portal hypertension and liver failure in humans.