Determination of hepatic clearance by derivations of the indocyanine green retention test in cirrhosis

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Background and Aim: The study was undertaken in order to compare single injection indocyanine green (ICG)-clearances with the steady-state ICG-clearance (ICGCl) in patients with cirrhosis in order to assess the most accurate estimate for ICG-clearance and to relate the ICG-clearances to established indicators of liver dysfunction. Methods: Thirty-eight patients (male 29) with cirrhosis (Child–Turcotte class A 8, class B 21, and class C 9) were studied during a hemodynamic investigation. A single injection of ICG was followed by blood samples for 5, 10, 15, and 20 min. The dose/plasma area clearance (ClA) and plasma volume · initial slope clearance (ClPV) were determined and compared with the steady-state infusion/plasma concentration ratio clearance (ICGCl). Results: The ClA (310; 214; 502 mL/min) and ClPV (294; 164; 481 mL/min) correlated closely with ICGCl (243; 120; 383 mL/min [median; interquartile range], R = 0.95–0.98, P < 0.000), but were significantly higher than ICGCl (P < 0.001). All three clearance measures correlated significantly with biochemical and hemodynamic variables of liver dysfunction (P < 0.05–0.000). All three ICG-clearances showed significantly lower values in patients with ascites compared to those without, and lower ICG-clearance values were present in patients with esophageal varices compared to those without (P < 0.05–0.002). Conclusion: Single injection markers (ClA and ClPV) of the steady-state ICG-clearance as derived from the ICG-retention curve and the plasma volume correlate with ICGCl and established variables of portal hypertension and liver cell bile excretory dysfunction. Therefore, these markers can safely replace the more costly ICGCl.

Original languageEnglish
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume37
Issue number4
Pages (from-to)692-699
Number of pages8
ISSN0815-9319
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

    Research areas

  • Excretory dysfunction, Hepatic dye uptake, Indocyanine green-clearance, Liver failure

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