Comparison of indocyanine green clearance with Child's-Pugh score and hepatic histology: a multivariate analysis.
OBJECTIVE
Indocyanine green clearance, measured by percentage disappearance rate, detects alterations in liver function and may be used as a non-invasive determinant of hepatic reserve. The aims of this study were to compare liver histology and Child's-Pugh score with percentage disappearance rate and determine which variables correlated with PDR.


METHODS
Child's-Pugh score, liver function tests, liver biopsies and indocyanine green testing (0.5mg/kg) were performed in 102 consecutive patients with cirrhosis of diverse etiologies. Indocyanine green concentration was determined using spectrophotometric analysis (806nm) and plotted logarithmically with Michaelis-Menten kinetics to calculate the percentage disappearance rate. Liver biopsies were graded using the modified Knodell score to obtain a histological activity index.


RESULTS
In bivariable analysis, percentage disappearance rate significantly correlated with Child's-Pugh score, albumin, bilirubin, prothrombin time and histological activity index. Albumin, prothrombin time and histological activity index were independent predictors of percentage disappearance rate in the final model (albumin p<0.01, prothrombin time p<0.046, histological activity index p=0.033), accounting for 46.2% of variability in percentage disappearance rate measurements.


CONCLUSIONS
Percentage disappearance rates correlated with Child's-Pugh scores in this series of cirrhotic patients. However, 46.2% of its variability was accounted for by albumin, prothrombin time and histological activity index.
Mukherjee
Sandeep
S
Liver Gallbladder Pancreas Center, Section of Gastroenterology and Hepatology, Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York, USA. smukherj@unmc.edu
Rogers
Mary A M
MA
Buniak
Borys
B
D004396:Coloring Agents / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D015999:Multivariate Analysis
D004396:Coloring Agents; D007208:Indocyanine Green