Assessment by pulse dye-densitometry indocyanine green (ICG) clearance test of hepatic function of patients before cardiac surgery: Its value as a predictor of serious postoperative liver dysfunction

AbstractThe indocyanine green (ICG) clearance test has been used to assess the reserve of hepatic function. This method is based on the spectrometric measurement of its plasma concentration at maximum wavelength of 805nm, which requires a spectrophotometer and associated maintenance. We established an ICG clearance test using a Toshiba 200FR automatic chemistry analyzer that can be tuned to a wavelength of approximately 805nm. Five pooled sera spiked from 0 to 4.0mg/dL were analyzed for linearity test and precision was determined at five levels in the range 0.1–2.0mg/dL. The ICG retention rate at 15min (R15) was determined for 38 patients using a conventional method and our method. The ICG clearance test using the automatic chemistry analyzer showed good linearity, and precision ranged from 0.3% to 1.0% for within-run CVs and from 0.6% to 4.7% for total CVs. The degree of agreement between the two methods was also acceptable (mean difference of 1.5%). It is expected that the ICG test using the automatic chemistry analyzer can replace the conventional ICG clearance test, considering the excellent agreement, good precision and linearity over a clinically relevant range.

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PP-159 Application and predictive value of indocyanine green (ICG) clearance test by pulse dye densitometry (PDD) in patients with liver failure

International Journal of Infectious Diseases ◽

10.1016/s1201-9712(11)60311-1 ◽

2011 ◽

Vol 15 ◽

pp. S90

Author(s):

A.-R. Hu ◽

S.-W. Jiang ◽

J.-M. Ye

Keyword(s):

Liver Failure ◽

Indocyanine Green ◽

Predictive Value ◽

Icg Clearance ◽

Icg Clearance Test ◽

Clearance Test

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The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function

10.21203/rs.3.rs-49059/v2 ◽

2020 ◽

Author(s):

JinLi Zheng ◽

Wei Xie ◽

Yang Huang ◽

Yunfeng Zhu ◽

Li Jiang

Keyword(s):

Risk Factors ◽

Indocyanine Green ◽

Retention Rate ◽

Liver Volume ◽

Volume Ratio ◽

Factors Affecting ◽

Icg Clearance ◽

Icg R15 ◽

Icg Clearance Test ◽

Clearance Test

Abstract Background: The indocyanine green(ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 minutes retention rate (ICG-R15) value. Results: We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15=0.36×TB (umol/L)- 0.78 × ALB(g/L) + 7.783×SNLR + 0.794×PT (s) - 0.016×PLT(/109) - 0.039× ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152=24.6650.382×TB (umol/L) - 0.799 × ALB(g/L) - 0.025 × PLT(/109) + 0.048 × AST(IU/L) - 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15≥10% was 0.861 and 0.857, respectively. Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.

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The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function

BMC Surgery ◽

10.1186/s12893-020-00952-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jinli Zheng ◽

Wei Xie ◽

Yang Huang ◽

Yunfeng Zhu ◽

Li Jiang

Keyword(s):

Risk Factors ◽

Indocyanine Green ◽

Retention Rate ◽

Liver Volume ◽

Volume Ratio ◽

Factors Affecting ◽

Icg Clearance ◽

Icg R15 ◽

Icg Clearance Test ◽

Clearance Test

Abstract Background The indocyanine green (ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy. Methods We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 min retention rate (ICG-R15) value. Results We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15 = 0.36 × TB (umol/L) − 0.78 × ALB(g/L) + 7.783 × SNLR + 0.794 × PT (s) − 0.016 × PLT(/109) − 0.039 × ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152 = 24.665 + 0.382 × TB (umol/L) − 0.799 × ALB(g/L) − 0.025 × PLT(/109) + 0.048 × AST(IU/L) − 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15 ≥ 10% was 0.861 and 0.857, respectively. Conclusion We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.

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The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function

10.21203/rs.3.rs-49059/v1 ◽

2020 ◽

Author(s):

JinLi Zheng ◽

Wei Xie ◽

Yang Huang ◽

Yunfeng Zhu ◽

Li Jiang

Keyword(s):

Risk Factors ◽

Indocyanine Green ◽

Retention Rate ◽

Liver Volume ◽

Volume Ratio ◽

Factors Affecting ◽

Icg Clearance ◽

Icg R15 ◽

Icg Clearance Test ◽

Clearance Test

Abstract Background: The indocyanine green(ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 minutes retention rate (ICG-R15) value.Results: We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15 = 0.36 × TB (umol/L)- 0.78 × ALB(g/L) + 7.783 × SNLR + 0.794 × PT (s) − 0.016 × PLT(/109) − 0.039 × ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152 = 24.6650.382 × TB (umol/L) − 0.799 × ALB(g/L) − 0.025 × PLT(/109) + 0.048 × AST(IU/L) − 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15 ≥ 10% was 0.861 and 0.857, respectively.Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.

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The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function

10.21203/rs.3.rs-49059/v3 ◽

2020 ◽

Author(s):

JinLi Zheng ◽

Wei Xie ◽

Yang Huang ◽

Yunfeng Zhu ◽

Li Jiang

Keyword(s):

Risk Factors ◽

Indocyanine Green ◽

Retention Rate ◽

Liver Volume ◽

Volume Ratio ◽

Factors Affecting ◽

Icg Clearance ◽

Icg R15 ◽

Icg Clearance Test ◽

Clearance Test

Abstract Background: The indocyanine green(ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 minutes retention rate (ICG-R15) value. Results：We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15=0.36×TB (umol/L) - 0.78 × ALB(g/L) + 7.783×SNLR + 0.794×PT (s) - 0.016×PLT(/109) - 0.039× ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152=24.665 + 0.382×TB (umol/L) - 0.799 × ALB(g/L) - 0.025 × PLT(/109) + 0.048 × AST(IU/L) - 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15≥10% was 0.861 and 0.857, respectively. Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.

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Comparison of preoperative two-dimensional shear wave elastography, indocyanine green clearance test and biomarkers for post hepatectomy liver failure prediction in patients with hepatocellular carcinoma

BMC Gastroenterology ◽

10.1186/s12876-021-01727-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rong Fu ◽

Tingting Qiu ◽

Wenwu Ling ◽

Qiang Lu ◽

Yan Luo

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Failure ◽

Indocyanine Green ◽

Validation Cohort ◽

Shear Wave Elastography ◽

Two Dimensional ◽

Icg Clearance ◽

Icg R15 ◽

Icg Clearance Test ◽

Clearance Test

Abstract Background The preoperative prediction of post hepatectomy liver failure (PHLF) is essential, but there is no gold standard for the prediction at present, and the efficacy of different methods for the prediction has not been compared systematically. In this study, we aimed to compare the efficacy of preoperative two-dimensional shear wave elastography (2D-SWE), indocyanine green (ICG) clearance test and biomarkers for PHLF prediction in patients with hepatocellular carcinoma (HCC). Methods We retrospectively studied 215 patients with HCC, who had undergone major liver resection in our hospital. Preoperative data of each patient, including liver stiffness value (LSV) of underlying hepatic parenchyma measured by 2D-SWE, ICG retention rate at 15 min (ICG-R15) measured by ICG clearance test, albumin-bilirubin (ALBI) scores, aspartate aminotransferase–platelet ratio index (APRI), and Fibrosis-4 (FIB-4) were collected for analysis. Post hepatectomy outcomes of study patients were also recorded for assessment of PHLF. The study patients were divided into development cohort (133 patients without PHLF, and 17 patients with PHLF) and validation cohort (59 patients without PHLF, and 6 patients with PHLF) randomly. Results In the development cohort, LSV, ICG-R15 and ALBI scores were significantly different between patients with and without PHLF, while no significant difference of APRI and FIB-4 scores was found. LSV had higher AUC (the area under the receiver operating characteristic curve) (AUC = 0.795) for PHLF prediction than ICG-R15 (AUC = 0.619) and ALBI scores (AUC = 0.686) (p < 0.05 for all comparisons). In the validation cohort, the cutoff value of LSV obtained from the development cohort, 10.35 kPa, revealed higher specificity (76.3%) for PHLF prediction than ICG-R15 (specificity: 66.1%) and ALBI scores (specificity: 69.5%) (p < 0.0001). Conclusions Compared with ICG-R15, ALBI scores, APRI and FIB-4, LSV measured by 2D-SWE may demonstrate better efficacy for preoperative PHLF prediction in patients with HCC.

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N-Acetylcysteine Supplementation for the Prevention of Postoperative Liver Dysfunction after On-Pump Cardiac Surgery

Turkish Journal of Anaesthesiology and Reanimation ◽

10.5152/tjar.2021.21370 ◽

2021 ◽

Author(s):

Rajeev Kumar ◽

◽

Manjari Bansal ◽

Soumya Sankar Nath ◽

Virendra Kumar ◽

...

Keyword(s):

Cardiac Surgery ◽

Liver Dysfunction ◽

Postoperative Liver Dysfunction

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Child-Pugh Parameters and Platelet Count as an Alternative to ICG Test for Assessing Liver Function for Major Hepatectomy

HPB Surgery ◽

10.1155/2017/2948030 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Kin-Pan Au ◽

See-Ching Chan ◽

Kenneth Siu-Ho Chok ◽

Albert Chi-Yan Chan ◽

Tan-To Cheung ◽

...

Keyword(s):

Platelet Count ◽

Liver Function ◽

Hospital Mortality ◽

Major Hepatectomy ◽

Retention Rate ◽

Disease Free Survival ◽

Term Survival ◽

Icg Clearance ◽

Icg Clearance Test ◽

Clearance Test

Objective. To study the correlations and discrepancies between Child-Pugh system and indocyanine green (ICG) clearance test in assessing liver function reserve and explore the possibility of combining two systems to gain an overall liver function assessment. Design. Retrospective analysis of 2832 hepatocellular carcinoma (HCC) patients graded as Child-Pugh A and Child-Pugh B with ICG clearance test being performed was conducted. Results. ICG retention rate at 15 minutes (ICG15) correlates with Child-Pugh score, however, with a large variance. Platelet count improves the correlation between Child-Pugh score and ICG15. ICG15 can be estimated using the following regression formula: estimated ICG15 (eICG15) = 45.1 + 0.435 × bilirubin − 0.917 × albumin + 0.491 × prothrombin time − 0.0283 × platelet (R2=0.455). Patients with eICG15 >20.0% who underwent major hepatectomy had a tendency towards more posthepatectomy liver failure (4.1% versus 8.0%, p=0.09) and higher in-hospital mortality (3.7% versus 8.0%, p=0.052). They also had shorter median overall survival (5.10±0.553 versus 3.01±0.878 years, p=0.015) and disease-free survival (1.37±0.215 versus 0.707±0.183 years, p=0.018). Conclusion. eICG15 can be predicted from Child-Pugh parameters and platelet count. eICG15 correlates with in-hospital mortality after major hepatectomy and predicts long-term survival.

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