title: The combination of MELD score and ICG liver testing predicts length of stay in the ICU and hospital mortality in liver transplant recipients.
abstract: BACKGROUND
  Early prediction of outcome would be useful for an optimal intensive care management of liver transplant recipients. Indocyanine green clearance can be measured non-invasively by pulse spectrophometry and is closely related to liver function.
  
  
  METHODS
  This study was undertaken to assess the predictive value of a combination of the model of end stage liver disease (MELD) score and early indocyanine plasma disappearance rates (ICG-PDR) for length of stay in the intensive care unit (ICU), length of stay in the hospital and hospital mortality in liver transplant recipients.
  
  
  RESULTS
  Fifty consecutive liver transplant recipients were included in this post Hoc single-center study. ICG-PDR was determined within 6 hours after ICU admission. Endpoints were length of stay in the ICU, length of hospital stay and hospital mortality. The combination of a high MELD score (MELD >25) and a low ICG-PDR clearance (ICG-PDR < 20%/minute) predicts a significant longer stay in the ICU (p = 0.004), a significant longer stay in the hospital (p < 0.001) and a hospital mortality of 40% vs. 0% (p = 0.003).
  
  
  CONCLUSIONS
  The combination of MELD scores and a singular ICG-PDR measurement in the early postoperative phase is an accurate predictor for outcome in liver transplant recipients. This easy-to-assess tool might be valuable for an optimal intensive care management of those patients.
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Klinzing
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Brandi
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stehberger
authors.affiliation: Department of Visceral- and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Raptis
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Béchir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007208:Indocyanine Green; D007902:Length of Stay / Q000639:trends; D008111:Liver Function Tests / Q000379:methods / Q000592:standards; D016031:Liver Transplantation / Q000401:mortality* / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D007208:Indocyanine Green
keywords: Hospital mortality; Indocyanine green liver testing; Length of stay in the ICU; MELD score
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