Assessment by pulse dye-densitometry indocyanine green (ICG) clearance test of hepatic function of patients before cardiac surgery: Its value as a predictor of serious postoperative liver dysfunction

Watanabe, Yasuhiko; Kumon, Keiji

doi:10.1016/s1053-0770(99)90267-7

Cited by 32 publications

(25 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The liver damage classification, which requires ICG test results, has been reported to be more effective for evaluation of hepatic function than the Child-Pugh classification [26,27] . On the other hand, the Child-Pugh classification may also be used in the evidence-based JSH guideline for consideration of nonsurgical treatment [3] .…”

Section: Discussionmentioning

confidence: 99%

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

et al. 2017

View full text Add to dashboard Cite

Aim/Background: The purpose of this study was to evaluate the validity of 3 classifications for assessing liver function, the liver damage and Child-Pugh classifications and the newly proposed albumin-bilirubin (ALBI) grade, in order to examine the feasibility of evaluating hepatic function using ALBI grade with the hepatocellular carcinoma (HCC) treatment algorithm used in Japan. Methods: We analyzed the medical records of 3,495 Japanese HCC patients admitted from 2000 to 2015, which were comprised of 1,580 patients hospitalized in the Ehime Prefecture area and used as a training cohort (Ehime group), and 1,915 others who were used for validation (validation group). ALBI score used for grading ( ≤ -2.60 = grade 1, greater than -2.60 to ≤ -1.39 = grade 2, greater than -1.39 = grade 3) as well as clinical features and prognosis (Japan Integrated Staging [JIS], modified JIS, ALBI-TNM [ALBI-T] score) were retrospectively investigated. Results: For prediction of liver damage A, the values for sensitivity and specificity, positive predictive and negative predictive values, and positive and negative likelihood ratios of ALBI-1 and Child-Pugh A were similar among the 2 groups. Akaike information criterion results showed that prognosis based on ALBI grade/ALBI-T score was better than that based on liver damage/modified JIS score and Child-Pugh/JIS score (22,291.8/21,989.4, 22,379.6/22,076.0, 22,392.1/22,075.1, respectively). The cutoff values for ALBI score for indocyanine green retention rate at 15 min (ICG-R15) <10, <20, and <30% were -2.623 (area under the curve [AUC]: 0.798), -2.470 (AUC: 0.791), and -2.222 (AUC: 0.843), respectively. The distribution of ICG-R15 (<10%, 10 to <20%, 20 to <30%, and ≥ 30%) for ALBI grade 1 was similar to that for liver damage A. There were only small differences with regard to therapeutic selection with the Japanese HCC treatment algorithm between liver damage and ALBI grade. Conclusion: ALBI grade is a useful and easy classification system for assessment of hepatic function for therapeutic decision making.

show abstract

Section: Discussionmentioning

confidence: 99%

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The results of these different tests do not all indicate the same degree of dysfunction among all patients. Moreover, although these parameters are clinically easy to use for estimating the operability, they are not sufficient to select the most suitable operative procedure [29] .…”

Section: Discussionmentioning

confidence: 99%

Open-Heart Surgery in Patients with Liver Cirrhosis: Indications, Risk Factors, and Clinical Outcomes

Zhong³

2007

Eur Surg Res

View full text Add to dashboard Cite

Background: Because of recent advances in cardiopulmonary bypass (CPB) surgery, there are broadened indications to approach patients with a high operative risk. Meanwhile, there is an increasing number of patients with severe liver dysfunction subjected to open-heart surgery. This retrospective study was designed to evaluate the operative indications and clinical outcomes in patients with liver cirrhosis (LC) undergoing open-heart surgery. In addition, determinants influencing their prognosis were assessed. Patients and Methods: Between May 1996 and June 2005, 24 patients with LC underwent CPB open-heart surgery in our institution. The preoperative severity of the LC was determined according to the Child-Pugh classification. Their perioperative data were analyzed. Several perioperative factors were compared by multivariate logistic regression analysis between survivors and nonsurvivors to determine possible risk factors contributing to mortality. Results:There were 14 females and 10 males. Their age ranged from 36 to 72 (mean 53 ± 13) years. Seventeen cases were classified as having Child-Pugh class A LC, 6 as having Child-Pugh class B, and 1 as having Child-Pugh class C LC. All patients underwent CPB surgery. The mean operation time and the cross-clamp time were 160 ± 53 and 90 ± 42 min, respectively. During the first 24 h after the operation, the mean chest tube output was 1,080 ± 320 ml. The mean duration of mechanical ventilation was 32 ± 22 h, and the mean intensive care unit stay was 11 ± 8 days. Sixty-six percent of the patients experienced significant morbidity. Fifty-three percent of the patients with Child-Pugh class A LC and 100% of those with Child-Pugh class B and C LC suffered postoperative complications. The overall mortality rate was 25%. The postoperative mortality rates of the patients with Child-Pugh class A, B, and C LC were 6, 67, and 100%, respectively. Preoperative serum total bilirubin and cholinesterase levels and EuroSCORE (European System for Cardiac Operative Risk Evaluation) values along with CPB time were identified as the important predictors to differentiate between survivors and nonsurvivors by multivariate logistic regression analysis. Conclusions: The Child-Pugh class is associated with hepatic decompensation and mortality after open-heart CPB surgery in patients with LC. Such surgery can be performed safely in patients with a Child-Pugh class A LC. But cardiac interventions using CPB in patients with more advanced LC are associated with high mortality and morbidity rates. The preoperative total plasma bilirubin and cholinesterase concentrations as well as the EuroSCORE along with the CPB time are identified as statistically significant predictors of mortality after open-heart surgery in patients with LC. Our findings indicate that patients with chronic liver disease scheduled for open-heart surgery should be carefully evaluated before the operation and that the CPB duration should be as short as possible.

show abstract

“…1 A few reports describe measuring hepatic functional reserve as a determinant of morbidity and mortality after cardiac surgery. [1][2][3][4] Attempts have been made to establish an accurate means of estimating both preoperative and postoperative functional reserve, to pres- The difference between the two groups was signifi cant (P < 0.05 by analysis ANOVA) ent liver failure after cardiac surgery. 1,2 The Child-Pugh classifi cation is commonly used to assess surgical risk in patients with chronic liver disease; 15 however, the predicted outcome suggested by this method is not always consistent with the actual outcome.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The Child-Pugh classifi cation is commonly used to assess surgical risk in patients with chronic liver disease; 15 however, the predicted outcome suggested by this method is not always consistent with the actual outcome. 1 We conducted a previous study on 16 patients with postoperative liver dysfunction, despite a Child-Pugh score of grade A. Watanabe et al 1 suggested that the ICGR15 value can be used for evaluating liver function to obtain a more accurate prediction of postoperative liver failure after cardiac surgery. However, in the present study, there was no signifi cant relationship between postoperative liver dysfunction and ICGR15.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Assessment of Congestive Liver Dysfunction Using Technetium-99 m Galactosyl Human Serum Albumin Liver Scintigraphy in Patients with Severe Valvular Heart Disease

et al. 2007

View full text Add to dashboard Cite

show abstract

Assessment by pulse dye-densitometry indocyanine green (ICG) clearance test of hepatic function of patients before cardiac surgery: Its value as a predictor of serious postoperative liver dysfunction

Cited by 32 publications

References 3 publications

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

Open-Heart Surgery in Patients with Liver Cirrhosis: Indications, Risk Factors, and Clinical Outcomes

Preoperative Assessment of Congestive Liver Dysfunction Using Technetium-99 m Galactosyl Human Serum Albumin Liver Scintigraphy in Patients with Severe Valvular Heart Disease

Contact Info

Product

Resources

About