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Indocyanine green elimination test in orthotopic liver recipients
Author(s) -
Tsubono T,
Todo S,
Jabbour N,
Mizoe A,
Warty V,
Demetris A J,
Starzl T E
Publication year - 1996
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510240531
Subject(s) - indocyanine green , medicine , liver transplantation , surgery , orthotopic liver transplantation , transplantation , nuclear medicine
Objective : To determine its predictive capability on graft quality and resultant clinical outcome, the indocyanine green (ICG) elimination test was performed by a spectrophotometric method and a noninvasive finger‐piece method with 50 orthotopic liver transplantations. Background : Early detection of poor‐functioning hepatic grafts is one of the most important issues in liver transplantation, but no reliable methods exist. Methods : The ICG test was performed after 50 orthotopic liver transplantations on postoperative days 1, 3, and 7. Indocyanine green elimination constants (K ICG ) were measured by both a standard spectrophotometric analysis (K ICG ‐B) and by a finger‐piece method (K ICG ‐F). The patients were followed for a minimum of 3 months after transplantation. Results of ICG tests were correlated with various clinical determinations. Results : Twelve of the 50 grafts were lost within three months, of which 7 were related to graft failure. Multivariate analysis using the Cox proportional hazard model revealed that K ICG on postoperative day 1 was a better predictor of liver‐ related graft outcome than any of the conventional liver function tests. Furthermore, K ICG values showed significant correlation with the severity of preservation injury, longer intensive care unit (ICU) and hospital stay, prolonged liver dysfunction, and septic complications. Correlation of K ICG values by the spectrophotometric method with those by the finger‐piece method was highly satisfactory in the grafts that had K ICG ‐B <0.15 min ‐1 (y = 0.868x ‐0.011, r = .955). Conclusion : The ICG elimination test, conducted spectrophotometrically or optically on the day after liver transplantation, is a reliable indicator of graft quality and subsequent graft outcome early after liver transplantation.