Journal
SEMINARS IN LIVER DISEASE
Volume 27, Issue 4, Pages 390-400Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-2007-991515
Keywords
endothelial cell; veno-occlusive disease; liver circulation; reperfusion injury; toxic hepatitis; liver fibrosis
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Injury to the hepatic microvasculature, the hepatic sinusoids, manifests in several ways. The sinusoidal endothelial cells (SECs) may lose porosity and scavenger function (capillarization); SECs may loosen from their tetherings to the space of Disse or even detach completely (ischemia-reperfusion injury, early sinusoidal obstruction syndrome, peliosis hepatis, early acetaminophen toxicity); the space of Disse may be completely denuded of sinusoidal lining cells that then embolize and obstruct the sinusold (early sinusoidal obstruction syndrome); or the sinusold may be obstructed by fibrosis (hepatic sinusoidal fibrosis, late sinusoidal obstruction syndrome). In many of these microvascular injuries, the change to the sinusold is a primary event that may lead to hepatocyte hypoxia with liver dysfunction and disruption of the portal circulation. With the exception of hepatic fibrosis, which will be reviewed elsewhere in this issue, each of these types of microvascular injuries will be described in this article
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