Contributions to the biology of the hypoxic liver. Note II. Histologic, electron microscopic and biochemical aspects in the course of open heart surgery under extracorporeal circulation.

A study was carried out on the evolution of histological and ultrastructural lesions of liver fragments harvested at different time intervals in the course of extracorporeal circulation in 62 patients operated for acquired and congenital heart disease, as well as that of serologic tests, pre-, intra- and postoperatively up to seven days. Morphologically, it is only the ultrastructural examination that detects the accentuation of preexisting hypoxic lesions within the framework of a state of "controlled shock", noting especially accentuated dilation of the endoplasmic reticulum, lysosomal activation, mitochondrial lesions and a tendency to ribosomal and glycogenic depletion. The lesions did not exceed the limits of reversibility, excepting the cases with advanced heart failure and cardiac cirrhosis.

Contributions to the biology of the hypoxic liver. Note I. Histological and electronmicroscopical aspects of the liver in chronic congestive heart failure.

A study was carried out on the histological and ultrastructural aspects of liver fragments harvested from 62 patients with acquired or congenital heart disease before open heart surgery under extracorporeal circulation. Against a background of passive congestion in the pericentrolobular and mediolobular areas, various mitochondrial lesions and dilation of the endoplasmic reticulum with a reduced number of ribosomes, the presence of microbodies, biliary pigments, lipid vacuoles, lysosomol hyperplasia and activation, glycogen depletion could be seen, as well as extensive collagenization of Disse's spaces, fibroblast hyperplasia and Kupffer cell activation. These lesions are more reduced in the periportal zones.