Clinical significance of the measurement of hepatic blood flow using xenon 133 and balloon catheter in patients undergoing treatment for hepatocellular carcinoma.

Total hepatic blood flow and portal blood flow were measured separately using a modified xenon 133 clearance method during angiography in 71 patients with chronic liver diseases, including 40 with proven hepatocellular carcinoma, and in 12 patients without detectable chronic liver injury who served as controls. Total hepatic and portal blood flow rates in controls were 805 +/- 149 ml/min and 667 +/- 206 ml/min, respectively. Total hepatic blood flow was significantly decreased in patients with compensated and decompensated liver cirrhosis (519 +/- 156 ml/min and 317 +/- 153 ml/min, respectively; P less than 0.01), as was portal blood flow (399 +/- 134 ml/min and 271 +/- 134 ml/min, respectively; P less than 0.01). Following transcatheter arterial embolization or hepatic resection (in 35 and 13 patients, respectively), hepatic failure occurred in 3 cases each. Embolization appeared contraindicated when hepatic portal blood flow was under 125 ml/min, and safe hepatic resection required an anticipated residual hepatic portal blood flow of at least 250 ml/min.