Incorporating indocyanin green clearance into the Model for End Stage Liver Disease (MELD-ICG) improves prognostic accuracy in intermediate to advanced cirrhosis

Zipprich, Alexander; Kuß, Oliver; Rogowski, Sebastian; Kleber, Gerhard; Lotterer, E.; Seufferlein, Thomas; Dollinger, Matthias

doi:10.1136/gut.2010.208595

Cited by 82 publications

(61 citation statements)

References 30 publications

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“…Moreover, other laboratory data, including the low platelet count, elevation of the fibrotic markers, slow ICG elimination and a delay in the GSA uptake, in the liver suggested that ascites in the present patient was induced by liver cirrhosis (12)(13)(14)(15). However, previous reports have demonstrated a discrepancy in the high TP level in the ascites if the ascites is caused by liver cirrhosis (4,10,16,17).…”

Section: Discussioncontrasting

confidence: 44%

Hypothyroidism Enhanced Portal Hypertension in a Patient with Alcoholic Liver Cirrhosis, Resulting in the Development of Ascites

et al. 2015

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A man diagnosed with alcoholic liver cirrhosis complained of abdominal distention due to massive ascites. The ascites did not resolve with diuretic agents. The serum-ascites albumin gradient value of 1.9 g/dL and the total protein level in the ascites of 3.1 g/dL indicated the ascites to have been caused by portal hypertension. Hypothyroidism was detected, and the patient received supplementation with levothyroxine. The ascites dramatically decreased after supplementation with levothyroxine. We herein conclude that the ascites in the present case had thus been strongly influenced by portal hypertension, which was induced by liver dysfunction associated with liver cirrhosis and hypothyroidism.

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Section: Discussioncontrasting

confidence: 44%

Hypothyroidism Enhanced Portal Hypertension in a Patient with Alcoholic Liver Cirrhosis, Resulting in the Development of Ascites

et al. 2015

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“…As above discussed, total liver blood flow and hepatic functional reserve are reflected by ICGR15, often used as a prognostic marker in decompensated cirrhotic patients and in candidates to resective liver surgery [50] . In cirrhotic patients admitted to resective surgery, preexisting PH and postoperative parenchymal dysfunction are among the most common causes of PHLF.…”

Section: Icgr15 In Ph: a Role As A Non Invasive Marker?mentioning

confidence: 99%

Indocyanine green kinetics to assess liver function: Ready for a clinical dynamic assessment in major liver surgery?

Gasperi

Mazza

Prosperi

2016

WJH

145

124

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Indocyanine green (ICG) kinetics (PDR/R15) used to quantitatively assess hepatic function in the perioperative period of major resective surgery and liver transplantation have been the object of an extensive, updated and critical review. New, non invasive bedside monitors (pulse dye densitometry technology) make this opportunity widely available in clinical practice. After having reviewed basic concepts of hepatic clearance, we analysed the most common indications ICG kinetic parameters have nowadays in clinical practice, focusing in particular on the diagnostic and prognostic role of PDR and R15 in the perioperative period of major liver surgery and liver transplantation. As recently pointed out, even if of extreme interest, ICG clearance parameters have still some limitations, to be considered when using these tests. Core tip: Non invasive monitors for indocyanine green (ICG) clearance (PDR and R15) are now available for a rapid assessment of liver function both in the intensive care unit and in major liver surgery. After having reviewed the basic concepts of hepatic clearance, we have analysed the most common indications of ICG kinetic parameters in clinical practice, focusing on the diagnostic and prognostic role of PDR and R15 in the perioperative period of major resective liver surgery and liver transplantation. Since ICG parameters have still some limitations, we will underline the conditions (mainly hyperbilirubinemia and severe peripheral hypoperfusion) able to alter the reliability of these tests.De Gasperi A, Mazza E, Prosperi M. Indocyanine green kinetics to assess liver function: Ready for a clinical dynamic assessment in major liver surgery? World

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“…It is also important to decide the proper time for liver transplantation and to choose the appropriate candidates for hepatic partial resection. 1,23 Estimating the functional reserve of the remnant liver in patients with liver cirrhosis or severe steatosis is especially important to minimize the risk of postoperative liver failure. Traditionally, indocyanin green (ICG) clearance test and scintigraphy with technetium-99m ( 99m Tc) mebrofenin have been used for evaluating liver function.…”

Section: Clinical Applications Of Gadoxetate-enhanced Mri Evaluation mentioning

confidence: 99%

Use of gadoxetate disodium for functional MRI based on its unique molecular mechanism

Choi¹,

Huh²,

Woo³

et al. 2016

BJR

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Gadolinium ethoxybenzyl dimeglumine (gadoxetate) is a recently developed hepatocyte-specific MRI contrast medium. Gadoxetate demonstrates unique pharmacokinetic and pharmacodynamic properties, because its uptake in hepatocytes occurs via the organic anion transporting polypeptide (OATP) transporter expressed at the sinusoidal membrane, and its biliary excretion via the multidrug resistance-associated proteins (MRPs) at the canalicular membrane. Based on these characteristics, gadoxetate-enhanced MRI can provide functional information on hepatobiliary diseases, including liver function estimation, biliary drainage evaluation and characterization of hepatocarcinogenesis. In addition, understanding its mode of action can provide an opportunity to use gadoxetate for cellular and molecular imaging. Radiologists and imaging scientists should be familiar with the basic mechanism of gadoxetate and OATP/MRP transporters.

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Incorporating indocyanin green clearance into the Model for End Stage Liver Disease (MELD-ICG) improves prognostic accuracy in intermediate to advanced cirrhosis

Abstract: ICG had the highest predictive value of the examined tests. Its incorporation into the MELD adds an estimation of liver blood flow and renders the new score MELD-ICG more accurate in predicting survival in intermediate to advanced cirrhosis than the MELD and MELD-Na.

Cited by 82 publications

References 30 publications

Hypothyroidism Enhanced Portal Hypertension in a Patient with Alcoholic Liver Cirrhosis, Resulting in the Development of Ascites

Hypothyroidism Enhanced Portal Hypertension in a Patient with Alcoholic Liver Cirrhosis, Resulting in the Development of Ascites

Indocyanine green kinetics to assess liver function: Ready for a clinical dynamic assessment in major liver surgery?

Use of gadoxetate disodium for functional MRI based on its unique molecular mechanism

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