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World J Hepatol. Jun 8, 2016; 8(16): 665-672
Published online Jun 8, 2016. doi: 10.4254/wjh.v8.i16.665
Mechanisms of adaptation of the hepatic vasculature to the deteriorating conditions of blood circulation in liver cirrhosis
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev, Dmitry Vladimirovich Belov
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev, Department of Faculty Surgery, South Ural State Medical University, 454092 Chelyabinsk, Russia
Dmitry Vladimirovich Belov, Department of Hospital Surgery, South Ural State Medical University, 454092 Chelyabinsk, Russia
Author contributions: Garbuzenko DV contributed to the conception and design; acquisition, analysis and interpretation of data; drafting the article; final approval of the version; all authors wrote this manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dmitry Victorovich Garbuzenko, MD, PhD, Professor, Department of Faculty Surgery, South Ural State Medical University, Box 12317, 454092 Chelyabinsk, Russia. garb@inbox.ru
Telephone: +8-909-7459826 Fax: +8-351-2687772
Received: March 12, 2016
Peer-review started: March 13, 2016
First decision: April 18, 2016
Revised: April 25, 2016
Accepted: May 17, 2016
Article in press: May 27, 2016
Published online: June 8, 2016
Processing time: 82 Days and 14.6 Hours
Abstract

PubMed, EMBASE, Orphanet, MIDLINE, Google Scholar and Cochrane Library were searched for articles published between 1983 and 2015. Relevant articles were selected by using the following terms: “Liver cirrhosis”, “Endothelial dysfunction”, “Sinusoidal remodeling”, “Intrahepatic angiogenesis” and “Pathogenesis of portal hypertension”. Then the reference lists of identified articles were searched for other relevant publications as well. Besides gross hepatic structural disorders related to diffuse fibrosis and formation of regenerative nodules, the complex morphofunctional rearrangement of the hepatic microvascular bed and intrahepatic angiogenesis also play important roles in hemodynamic disturbances in liver cirrhosis. It is characterized by endothelial dysfunction and impaired paracrine interaction between activated stellate hepatocytes and sinusoidal endotheliocytes, sinusoidal remodeling and capillarization, as well as development of the collateral microcirculation. In spite of the fact that complex morphofunctional rearrangement of the hepatic microvascular bed and intrahepatic angiogenesis in liver cirrhosis are the compensatory-adaptive reaction to the deteriorating conditions of blood circulation, they contribute to progression of disease and development of serious complications, in particular, related to portal hypertension.

Keywords: Liver cirrhosis; Endothelial dysfunction; Sinusoidal remodeling; Intrahepatic angiogenesis; Pathogenesis of portal hypertension

Core tip: Besides gross hepatic structural disorders related to diffuse fibrosis and formation of regenerative nodules, the complex morphofunctional rearrangement of the hepatic microvascular bed and intrahepatic angiogenesis play important roles in hemodynamic disturbances in liver cirrhosis. In spite of the fact that these changes of the hepatic vasculature are the compensatory-adaptive reaction to the deteriorating conditions of blood circulation, they contribute to the progression of disease and development of serious complications, in particular, related to portal hypertension.