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Computational hemodynamics of portal vein hypertension in hepatic cirrhosis patients

Portal vein hypertension generally occurs in liver diseases like hepatic cirrhosis. It causes hemodynamic changes that are closely related to liver disease. At advanced stages of hepatic cirrhosis, portal vein hypertension leads to the atrophy of the right lobe of the liver and the hypertrophy of the left lobe through a process that has not yet been fully explained. Based on the hemodynamic changes that are known to occur, we hypothesize that liver volume is related to the distribution of blood flowing from the splenic vein (SV) that carries hepatotrophic factors from the spleen and pancreas. We studied blood flow in the portal vein system to validate this hypothesis through in vitro experimentation and a computational fluid dynamics (CFD) analysis involving both simplified and patient-specific models based on four healthy subjects and two patients with liver cirrhosis. The results confirmed the hypothesis that right-lobe atrophy is significantly influenced by the distribution of blood from the SV. Moreover, the patients with liver cirrhosis had a significantly larger mass fraction of spleen-derived blood in the left portal vein branch (LPV) than healthy subjects, a result consistent with right-lobe atrophy and left-lobe hypertrophy.