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K ICG value, a reliable real‐time estimator of graft function, accurately predicts outcomes in adult living‐donor liver transplantation
Author(s) -
Hori Tomohide,
Iida Taku,
Yagi Shintaro,
Taniguchi Kentaro,
Yamamoto Chiduru,
Mizuno Shugo,
Yamagiwa Kentaro,
Isaji Shuji,
Uemoto Shinji
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20713
Subject(s) - medicine , indocyanine green , liver transplantation , living donor liver transplantation , liver function , hemodynamics , surgery , transplantation
Reliable monitoring enabling evaluation of graft function is crucial after living‐donor liver transplantation (LDLT). A method to identify poor graft function at an early postoperative period would allow opportune intensive clinical management to bring about further improvements in LDLT outcomes. This study assessed the reliability of the indocyanine green (ICG) elimination rate constant (K ICG ) value as an estimator of graft function and determined the actual temporal changes of K ICG after LDLT. K ICG values were measured using a noninvasive method in 30 adult recipients up to 28 days after LDLT. The receptor index (LHL15) based on liver scintigraphy, and graft parenchymal damage score based on histopathological findings were evaluated after LDLT and correlated well with simultaneous K ICG . Thus, K ICG measured by noninvasive method was confirmed as accurately evaluating graft function. Changes of K ICG after LDLT in recipients with good graft function were maintained, after some falls in the early periods, and had a significant difference compared with those for recipients without good graft function; moreover, there were already significant differences in K ICG 24 hours after LDLT. Mean transit time reflecting systemic hemodynamics revealed that recipients without good outcomes fell into an unstable systemic hemodynamic state, and effective hepatic blood flow has a large influence on liver regeneration after LDLT. In conclusion, we suggested that K ICG values can predict clinical outcomes at the early postoperative period after LDLT by sharply reflecting the influence of systemic dynamics on splanchnic circulation. Liver Transpl 12:605–613, 2006. © 2006 AASLD.