The space between the endothelium and the cords is named the space of Disse . Its location is that of connective tissue, and it does contain a network of reticular fibers (collagen type III) which hold the hepatocytes together. More significantly, since the fenestrations of the endothelium permit free movement of blood plasma, the "interstitial fluid" of the space of Disse is blood plasma. Hence, for all practical purposes, hepatocytes reside in direct contact with blood.
Acute liver failure may also be diagnosed in patients with previously undiagnosed Wilson disease, vertically acquired hepatitis B virus, or autoimmune hepatitis, in whom underlying cirrhosis may be present, provided the disease has been recognized for <26 weeks. On the other hand, patients with acute severe alcoholic hepatitis, even if recognized for <26 weeks, are considered to have acute-on-chronic liver failure since most have a long history of heavy drinking. The approach to such patients is discussed elsewhere. (See "Clinical manifestations and diagnosis of alcoholic fatty liver disease and alcoholic cirrhosis" and "Prognosis and management of alcoholic fatty liver disease and alcoholic cirrhosis" .)