title: Indocyanine green plasma disappearance rate during the anhepatic phase of orthotopic liver transplantation.
abstract: Non-invasive pulse spectrophotometry to measure indocyanine green (ICG) elimination correlates well with the conventional invasive ICG clearance test. Nevertheless, the precision of this method remains unclear for any application, including small-for-size liver remnants. We therefore measured ICG plasma disappearance rate (PDR) during the anhepatic phase of orthotopic liver transplantation using pulse spectrophotometry. Measurements were done in 24 patients. The median PDR after exclusion of two outliers and two patients with inconstant signal was 1.55%/min (95% confidence interval [CI]=0.8-2.2). No correlation with patient age, gender, body mass, blood loss, administration of fresh frozen plasma, norepinephrine dose, postoperative albumin (serum), or difference in pre and post transplant body weight was detected. In conclusion, we found an ICG-PDR different from zero in the anhepatic phase, an overestimation that may arise in particular from a redistribution into the interstitial space. If ICG pulse spectrophotometry is used to measure functional hepatic reserve, the verified average difference from zero (1.55%/min) determined in our study needs to be taken into account.
authors.affiliation: Department of Visceral and Transplant Surgery, University Hospital Bern, CH-3010, Bern, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Bruegger
authors.forename: Peter
authors.initials: P
authors.lastname: Studer
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Schmid
authors.forename: Gunther
authors.initials: G
authors.lastname: Pestel
authors.forename: Juerg
authors.initials: J
authors.lastname: Reichen
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
authors.forename: Daniel
authors.initials: D
authors.lastname: Candinas
authors.forename: Daniel
authors.initials: D
authors.lastname: Inderbitzin
mesh_terms: D000328:Adult; D000368:Aged; D004396:Coloring Agents / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013053:Spectrophotometry / Q000379:methods
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green