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The Liver and Pancreas Remarkable Organs of Intelligent Design John R. Galloway, MD Professor of Surgery Emory School of Medicine The Liver and Pancreas A Story How Fred, the cadaver, and his liver taught me the importance of Christian Apologetics The Liver and Pancreas The Liver, Pancreas and Me My Uncle Tom with Alcoholic Cirrhosis Emory Clinical Research Facility: Nutrition and metabolism research in patients with liver disease as a medical student My first patient: 45 year old dairy farmer with pancreatic cancer The Liver and Pancreas General Outline 1. 2. 3. 4. 5. Embryology Anatomy: Macro and Micro Blood Supply Physiology and Function Intelligent Design Applications The Liver and Pancreas Major Themes 1. Irreducible and specified complexity exists not only at the cellular level but also within the organ as a whole. 2. Complexity does increase as you go from: * External to Internal * Macro to Micro * Total function to individual function 3. Absolutely intricate and intimate relationships exists between individual organs and other organ systems as well as the body as a whole. The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas Physiological Units of the Liver Hepatocytes Vascular Blood Supply Reticulo-endothelial System Biliary System * 2 to 4 lbs; 3 billion cells; 500 functions * The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas Functions of the Liver 1. Metabolism of basic nutrients 2. Phagocytosis and immunological surveillance 3. Detoxification 4. Vitamin metabolism 5. Coagulation factors 6. Bile formation and excretion 7. Energy storage 8. Cholesterol control 9. Maintains hormonal balance 10. Protein synthesis The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver as an Irreducibly Complex Organ System ** Each physiological unit must function for the organ to perform its role 1. 2. 3. 4. 5. Hepatic artery blockage: bile ducts die Portal vein blockage: liver atrophy Hepatic vein blockage: liver cells die Vitamin K deficiency: poor blood clotting Remove RES: loss of filtering and poor immune status 6. Loss of nerve supply: uncoordinated bile flow 7. Liver cell death: failed nutrient metabolism and detox capability The Liver and Pancreas ** The interdependency between the Liver and Body as a whole demonstrated in Liver Failure 1. Altered amino acid metabolism BCAA Skeletal mass AAA Liver coma 2. Altered CHO metabolism glycogen quick energy sugar malnutrition The Liver and Pancreas 3. Altered Fat Metabolism Bile poor digestion Fat in liver hepatitis 4. Altered Sodium and Water Homeostasis Kidney fxn Ascites, edema 5. Altered Immune System Increased infection 6. Altered blood flow to liver Congestive Heart Failure The Liver and Pancreas 7. Liver damage: Hepatopulmonary Syndrome Lung failure 8. Liver damage: BM Failure anemia, leukopenenia, Platelets 9. Altered Hormone Metabolism Sterility The Liver and Pancreas The Liver and Pancreas Liver Regeneration When the liver is damaged or removed, it has the ability to regenerate 75% Remaining healthy cells move from growth arrested state to proliferation phase Continues day to day physiological function Hepatotrophic growth factors from small bowel and pancreas: insulin, glucagon The Liver and Pancreas Functions of the Pancreas 1. Exocrine: produce and secrete enzymes of digestion 2. Endocrine: glucose control through production and secretion of Insulin and Glucagon The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas The Liver and Pancreas Some Take Home Points 1. The Liver and Pancreas are organs of enormous complexity. 2. Their unique location between the intestines and the rest of the body is ideally designed to allow them to perform their roles in substrate metabolism and homeostasis. 3. They are divided up into anatomical and physiological units; each of which must be maintained for the organ as a whole to function properly. The Liver and Pancreas 4. Complex protective mechanisms exist to protect the anatomical and physiological integrity of each organ. 5. The concept of irreducible complexity extends to the body as a whole when the intricate inter-organ relationships between the liver, pancreas and other organs are considered. The Liver and Pancreas Theological Applications 1. Commonality in organ systems that exists between species does not necessarily indicate that one species evolved from another. Such similarities can be more readily explained by a COMMON CREATOR who incorporated common features of design. 2. The Liver and Pancreas as well as other organs and the body as a whole demonstrate a sheer universality of perfection; and to whatever depth we look, we find an elegance and ingenuity of absolute transcending quality and quantity. The Liver and Pancreas 3. Is it really credible that the totally random and purposeless process of evolution could have constructed a reality that is the very antithesis of chance? 4. “As a surgeon, when I open up the abdomen and see organs of such intricacy, I realize that there simply has not been enough time for natural evolutionary processes to have developed them.” C. Everett Koop MD Surgeon General The Liver and Pancreas Final Thoughts Every human body is a miracle exceeding our comprehension. The complexity and dimension involved stagger our minds and strain our ability to apprehend its grandeur. Yet, as we make the noble effort to search for the meaning behind the biology, We are edified on multiple levels: * We see the power and precision of God. * We are increasingly aware of the intimacy with which He carries out His creative acts. The Liver and Pancreas * We are reminded that God has a triple claim on our lives as creator, sustainer, and redeemer. * We, therefore, relinquish our Body back to Him; yielding to the One who cares for us more than we ourselves… * And in this glad surrender, we find Purpose, Freedom, Joy, Hope and Love.