Key messages

• There are two inflow circuits: high-pressure high-resistance hepatic artery blood mixes with low-pressure low-resistance portal vein blood to form sinusoidal capillaries.

• The portal vein provides two-thirds of total hepatic blood flow and the hepatic artery provides the other third. However, because of differences between the arterial and venous oxygen contents, two-thirds of the hepatic oxygen supply is derived from the hepatic arterial circulation.

• The liver is the main site of protein synthesis, including albumin and coagulation factors. It is essential for carbohydrate metabolism by increasing glycogen synthesis when the serum glucose concentration is high, and degrading glycogen or converting amino acids to glucose by gluconeogenesis when the serum glucose concentration is low. The liver is also responsible for both chylomicron degradation and lipoprotein synthesis.

• An intrahepatic regulation of hepatic protein synthesis occurs during inflammation, with a shift towards enhanced production of acute phase proteins such as C-reactive protein, serum amyloid A, lipopolysaccharide-binding protein, and complement components.

• The liver protects the organism from the deleterious accumulation of useless metabolites and various toxic compounds of both endogenous and exogenous origin.

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