Determination of hepatic clearance by derivations of the indocyanine green retention test in cirrhosis
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Determination of hepatic clearance by derivations of the indocyanine green retention test in cirrhosis. / Møller, Søren; Henriksen, Jens H.; Sjöstedt, Sannia; Bendtsen, Flemming.
In: Journal of Gastroenterology and Hepatology (Australia), Vol. 37, No. 4, 2022, p. 692-699.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Determination of hepatic clearance by derivations of the indocyanine green retention test in cirrhosis
AU - Møller, Søren
AU - Henriksen, Jens H.
AU - Sjöstedt, Sannia
AU - Bendtsen, Flemming
N1 - Publisher Copyright: © 2022 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Excretory dysfunction
KW - Hepatic dye uptake
KW - Indocyanine green-clearance
KW - Liver failure
U2 - 10.1111/jgh.15778
DO - 10.1111/jgh.15778
M3 - Journal article
C2 - 35016257
AN - SCOPUS:85124887675
VL - 37
SP - 692
EP - 699
JO - Journal of Gastroenterology and Hepatology
JF - Journal of Gastroenterology and Hepatology
SN - 0815-9319
IS - 4
ER -
ID: 309126078