Indocyanine green fluoroscopy and liver transplantation: a new technique for the intraoperative assessment of bile duct vascularization

Coubeau, Laurent; Frezin, Julie; Dehon, Romain; Lerut, Jan; Reding, Raymond

doi:10.1016/s1499-3872(17)60040-7

Cited by 5 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…64,65 No biliary complications were reported in the total of 7 cases, but these data were limited to case series and small numbers. 64,65 Similarly, ICG fluorescence can be used to assess the perfusion of the liver itself during LT. A number of case reports reported ICG fluorescence being used intraoperatively in this way to identify and manage portal vein thrombosis, to visualize an area of ischemia that requires resection after hepatic artery thrombosis, and to confirm viability of segment IV after split LT. 63,66,67 Additionally, selective clamping or intraportal injection of ICG allows direct visualization of the segmental anatomy of the liver. 73,75 During living donor LT, this can facilitate parenchymal transection along the true line of ischemia and minimize revascularized liver parenchyma in the donor or recipient.…”

Section: Icg Fluorescence For Perfusion Assessmentmentioning

confidence: 99%

“…This has been used by 2 groups to confirm that the distal bile duct was well vascularized before anastomosis and therefore theoretically reduces the risk of biliary complications. 64,65 No biliary complications were reported in the total of 7 cases, but these data were limited to case series and small numbers. 64,65 Similarly, ICG fluorescence can be used to assess the perfusion of the liver itself during LT. A number of case reports reported ICG fluorescence being used intraoperatively in this way to identify and manage portal vein thrombosis, to visualize an area of ischemia that requires resection after hepatic artery thrombosis, and to confirm viability of segment IV after split LT. 63,66,67 Additionally, selective clamping or intraportal injection of ICG allows direct visualization of the segmental anatomy of the liver.…”

Section: Icg Fluorescence For Perfusion Assessmentmentioning

confidence: 99%

Section: Adverse Effects and Safetymentioning

confidence: 99%

See 2 more Smart Citations

Current and Potential Applications for Indocyanine Green in Liver Transplantation

Lau

Liu

et al. 2021

Transplantation

View full text Add to dashboard Cite

Indocyanine green (ICG) is a fluorescent dye taken up and almost exclusively cleared by the liver. Measurement of its clearance and visualization of its fluorescence make it suitable for a number of potential applications in liver transplantation including assessment of liver function and real-time assessment of arterial, venous, and biliary structures. ICG clearance can be used to assess donor graft quality before procurement and graft metabolic function before transplant using normothermic ex vivo machine perfusion. ICG clearance in the post–liver transplantation period is able to predict recipient outcomes with correlations to early allograft dysfunction and postoperative complications. After absorbing light in the near-infrared spectrum, ICG also emits fluorescence at 835 nm. This allows the assessment of vascular patency after reconstruction and patterns of liver perfusion in real time. ICG perfusion patterns after revascularization are also associated with posttransplant graft function and survival. ICG fluorescence cholangiography is routine in a number of centers and acts as an aid to identifying the optimal point of bile duct division during living donor liver transplantation to optimize safety for both donor and recipient. In summary, ICG is a versatile tool and has a number of useful applications in the liver transplantation journey including assessment of liver function, perfusion assessment, and cholangiography. Further research and clinical trials are required to validate and standardize its routine use in liver transplantation.

show abstract

Section: Icg Fluorescence For Perfusion Assessmentmentioning

confidence: 99%

Section: Icg Fluorescence For Perfusion Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Current and Potential Applications for Indocyanine Green in Liver Transplantation

Lau

Liu

et al. 2021

Transplantation

View full text Add to dashboard Cite

show abstract

“…Doses for intraoperative assessment have been established empirically by using different amounts of ICG in various centers utilizing NIRF technology. Like with all fluorescent dyes quenching is a major disadvantage, meaning that at high concentrations of ICG the fluorescent effect stops following a linear increase and diminishes, fluorescence being absorbed by the fluorophore itself (28). From this point of view some authors have titrated from small concentrations to large concentrations, others have decided to administer ICG at 3 hours preoperatively, others with 24 hours before surgery.…”

Section: • Colorectal Surgerymentioning

confidence: 99%

Indocyanine green enhanced surgery; principle, clinical applications and future research directions

Aliuș¹,

Oprescu²,

Bălălău³

et al. 2018

J Clin Invest Surg.

View full text Add to dashboard Cite

Over the past decade a new emergent technology has become very popular in all fields of surgery using Indocyanine green and near infrared fluorescent optical systems. This revolutionary approach overlaps conventional and near infrared images to produce highly informative intraoperative images on the anatomy and physiology of various tissues. Near infrared fluorescence is employed for perioperative angiography in vascular mapping, assessment of anastomoses, location of sentinel lymph nodes and delineation of biliary tree anatomy, highlighting tumours and metastatic deposits, improving surgical techniques and for many other uses. A lot of researchers have reported better surgical outcomes and technique innovations facilitated by this novel technology which although in its early stages, it lights up great interest worldwide. This article reviews the principle of the method, the properties of the fluorescent dye, the main clinical applications and discusses future research directions.

show abstract

“…The Model of Early Allograft Function (MEAF) grades the severity of liver graft dysfunction by a continuous score, based on bilirubin, international normalized ratio, and alanine aminotransferase within three days post-transplant, and it is a prognostic tool for 3, 6 and 12-month patient and graft survival [6,7]. Indocyanine green (ICG) is a cyanine dye safely used in medical diagnostics; although with different techniques, ICG boasts broad applications from vascular and lymphatic perfusion assessments in the fields of gastrointestinal surgery and gynecology, to the vascular and organ functional assessment in hepatology [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Association between the donor to recipient ICG-PDR variation rate and the functional recovery of the graft after orthotopic liver transplantation: A case series

et al. 2021

View full text Add to dashboard Cite

Background Despite current advances in liver transplant surgery, post-operative early allograft dysfunction still complicates the patient prognosis and graft survival. The transition from the donor has not been yet fully understood, and no study quantifies if and how the liver function changes through its transfer to the recipient. The indocyanine green dye plasma disappearance rate (ICG-PDR) is a simple validated tool of liver function assessment. The variation rate between the donor and recipient ICG-PDR still needs to be investigated. Materials and methods Single-center retrospective study. ICG-PDR determinations were performed before graft retrieval (T1) and 24 hours after transplant (T2). The ICG-PDR relative variation rate between T1 and T2 was calculated to assess the graft function and suffering/recovering. Matched data were compared with the MEAF model of graft dysfunction. Objective To investigate whether the variation rate between the donor ICG-PDR value and the recipient ICG-PDR measurement on first postoperative day (POD1) can be associated with the MEAF score. Results 36 ICG-PDR measurements between 18 donors and 18 graft recipients were performed. The mean donor ICG-PDR was 22.64 (SD 6.35), and the mean receiver’s ICG-PDR on 1st POD was 17.68 (SD 6.60), with a mean MEAF value of 4.51 (SD 1.23). Pearson’s test stressed a good, linear inverse correlation between the ICG-PDR relative variation and the MEAF values, correlation coefficient -0.580 (p = 0.012). Conclusion The direct correlation between the donor to recipient ICG-PDR variation rate and MEAF was found. Measurements at T1 and T2 showed an up- or downtrend of the graft performance that reflect the MEAF values.

show abstract

Indocyanine green fluoroscopy and liver transplantation: a new technique for the intraoperative assessment of bile duct vascularization

Cited by 5 publications

References 10 publications

Current and Potential Applications for Indocyanine Green in Liver Transplantation

Current and Potential Applications for Indocyanine Green in Liver Transplantation

Indocyanine green enhanced surgery; principle, clinical applications and future research directions

Association between the donor to recipient ICG-PDR variation rate and the functional recovery of the graft after orthotopic liver transplantation: A case series

Contact Info

Product

Resources

About