Hepatic Veins

Medically Reviewed by Jennifer Robinson, MD on August 11, 2022
3 min read

Hepatic veins are blood vessels that return low-oxygen blood from your liver back to the heart. The veins are key players in the supply chain that moves the blood that delivers nutrients and oxygen to every cell in your body.

A blockage in one of the hepatic veins may damage your liver.

"Hepatic" means relating to the liver. The wedge-shaped organ is your largest one after your skin. The liver’s tasks include converting nutrients passed from your digestive tract into energy, getting rid of toxins, and sorting out waste that your kidneys flush out as pee.

Doctors divide the liver into eight sections to map it for surgeries and tests.

Your three main hepatic veins run between the eight segments like borders.

The middle hepatic vein is the longest. It divides the liver into the right and left lobes. The right hepatic vein is the largest. It divides your liver’s right lobe from front to back. The left hepatic vein divides the left lobe from left to right.

Each hepatic vein can have two or more branches inside the liver. The three main hepatic veins link up at the top of your liver at the inferior vena cava, a large vein that drains the liver to your right heart chamber.

On the bottom end of the liver are the organ’s unusual double blood supplies. One is the hepatic artery, which brings in oxygen-rich blood from the heart. The other is the portal vein, which delivers blood from your stomach, intestines, and the rest of your digestive system.

Your blood supplies oxygen and nutrients to all the tissues of your body. By the time the blood reaches the liver, a lot of its oxygen is gone. Doctors call this deoxygenated blood. The job of the hepatic veins is to move this blood out of your liver. It’s hard work. At any given time, your liver holds about a pint of blood, or about 1/8th of your body’s total blood.

The inferior vena cava carries deoxygenated blood from your liver and the lower half of your body to the right side of your heart. From there, the blood flows to your lungs, where it takes on fresh oxygen and gets rid of carbon dioxide as you breathe.

Sometimes one or more hepatic veins can narrow or get blocked, so blood can’t flow back to your heart. The cause is often a blood clot or growth.

Other things that can block the hepatic veins include:

A blocked hepatic vein can damage your liver and lead to a condition called Budd-Chiari syndrome. Symptoms may come on over weeks or months. You might have severe pain right away or no symptoms until the disease gets worse. Without treatment, it can lead to liver failure, cirrhosis (scarring in the liver), or other serious problems.

Your doctor likely will first treat the clot or other reasons for the blockage. Sometimes surgery can widen the veins or switch blood flow from one vein to another. In severe cases, you may need a liver transplant.