Intermittent ischemia enhances the uptake of indocyanine green to livers subject to ischemia and reperfusion

Steenks, Mathilde; Peters, Jeroen; Rademacher, Willem; Nieuwenhuijs, Vincent B.; Padbury, Robert; Barritt, Greg J.

doi:10.1111/j.1440-1746.2012.07169.x

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…The principle of the ICG test consists of the hepatic parenchyma eliminating ICG into bile in an unchanged form 22 . Since the elimination rate of ICG is highly dependent on blood flow and bile flow 23 , the ICG plasma clearance test does not exclusively reflect the hepatocellular compartment of the liver. The ICG plasma clearance is presumably a surrogate marker for the flow in the hepatic artery and the portal vein, which does not predict the post-transplantation outcome of a liver graft 5 .…”

Section: Discussionmentioning

confidence: 99%

A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

Schurink

Haan

Willemse

et al. 2021

Sci Rep

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No single reliable parameter exists to assess liver graft function of extended criteria donors during ex-vivo normothermic machine perfusion (NMP). The liver maximum capacity (LiMAx) test is a clinically validated cytochromal breath test, measuring liver function based on 13CO2 production. As an innovative concept, we aimed to integrate the LiMAx breath test with NMP to assess organ function. Eleven human livers were perfused using NMP. After one hour of stabilization, LiMAx testing was performed. Injury markers (ALT, AST, miR-122, FMN, and Suzuki-score) and lactate clearance were measured and related to LiMAx values. LiMAx values ranged between 111 and 1838 µg/kg/h, and performing consecutive LiMAx tests during longer NMP was feasible. No correlation was found between LiMAx value and miR-122 and FMN levels in the perfusate. However, a significant inverse correlation was found between LiMAx value and histological injury (Suzuki-score, R = − 0.874, P < 0.001), AST (R = − 0.812, P = 0.004) and ALT (R = − 0.687, P = 0.028). Furthermore, a significant correlation was found with lactate clearance (R = 0.683, P = 0.043). We demonstrate, as proof of principle, that liver function during NMP can be quantified using the LiMAx test, illustrating a positive correlation with traditional injury markers. This new breath-test application separates livers with adequate cytochromal liver function from inadequate ones and may support decision-making in the safe utilization of extended criteria donor grafts.

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Section: Discussionmentioning

confidence: 99%

A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

Schurink

Haan

Willemse

et al. 2021

Sci Rep

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“…Indocyanine green (ICG) clearance test was carried out to quantify the capacity of remaining functional hepatocytes by detecting the clearance ability of the liver to ICG metabolism, biotransformation, and excretion, which can be used to assess the liver reserve capacity dynamically [ 11 ]. ICG retention ratio after 15 minutes (ICG R15), ICG plasma clearance rate (ICG K value), and effective hepatic blood flow (EHBF) were calculated to reflect the liver reserve capacity [ 12 ]. ICG clearance tests were carried out by DDG-3300K analyzer (Optoelectronic Industry, Japan).…”

Section: Methodsmentioning

confidence: 99%

Protective Efficiency Comparison of Direct and Remote Ischemic Preconditioning on Ischemia Reperfusion Injury of the Liver in Patients Undergoing Partial Hepatectomy

Kong

Yuan

et al. 2023

BioMed Research International

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Objective. Ischemia reperfusion injury greatly damages liver function and deteriorates the prognosis of patients undergoing partial hepatectomy. This study is to compare the protective efficiency of direct and remote ischemic preconditioning (DIPC and RIPC) on ischemia reperfusion injury of the liver in patients undergoing partial hepatectomy. Methods. 90 patients scheduled for partial hepatectomy were enrolled and randomly divided into control ( n = 30 ), DIPC ( n = 30 ), and RIPC ( n = 30 ) groups. Baseline and surgery characteristics were collected, and ischemic preconditioning methods were carried out. Intraoperative hemodynamics, liver function and liver reserve capacity, oxidative stress, and inflammatory responses were measured, and the incidence of postoperative adverse reactions was calculated finally. Results. 10 patients were excluded from the study, and finally, the eligible patients in three groups were 27, 28, and 25, separately. No significant differences were observed in baseline and surgery characteristics among the three groups. SBP and DBP were significantly higher after hepatic portal vein occlusion while they were significantly lower after surgery in the DIPC and RIPC groups compared with that in the control group, SBP and DBP were of great fluctuation at different time points in the control group while they showed much more stabilization in the DIPC and RIPC groups. ALT, AST, and TBIL were significantly decreased on days 1, 3, and 5 after surgery, and ICG R15 was significantly decreased while ICG K value and EHBF were significantly increased on day 1 after surgery in the DIPC and RIPC groups compared with that in the control group. Moreover, antioxidant enzyme SOD was increased, and inflammatory factors TNF-α and IL-1β were decreased 24 hours after surgery in the DIPC and RIPC groups compared with that in the control group. DIPC and RIPC also decreased hospital stays and the incidence of nausea, vomiting, and hypertension. Conclusion. DIPC and RIPC both alleviated ischemia reperfusion injury of the liver and reduced perioperative complications with similar protective efficiency in patients undergoing partial hepatectomy.

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“…ICG is extracted from the blood by normal hepatocytes and excreted into the bile. HCC cells do not excrete ICG; it is retained in HCC cells and can be detected using a camera up to several days (3). ICG imaging technique enabled highly sensitive identification of HCCs by visualizing the disordered biliary excretion of ICG.…”

Section: Introductionmentioning

confidence: 99%

The Advantages of Indocyanine Green Fluorescence Imaging in Detecting and Treating Pediatric Hepatoblastoma: A Preliminary Experience

et al. 2021

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Background: Currently, indocyanine green (ICG) fluorescence imaging enables radical surgical resection in hepatoblastoma (HB) and has beneficial uses; however, its usage in pediatric patients is still limited.Methods: From 2015 to 2019, 17 hepatoblastoma patients underwent 22 fluorescence-guided surgery using ICG. ICG (0.3 mg/kg) was intravenously injected 24–48 h before the operation. With ICG/NIR camera, intraoperative identification of biological structures and demarcation of mass were conducted.Results: ICG fluorescence-guided surgery was performed for hepatoblastoma in 22 cases: 16, 1, and 2 cases underwent anatomic resection, partial hepatectomy, and liver transplantation, respectively. Six patients accompanied lung metastasis at the time of surgery, and two patients underwent lung surgery using ICG. The median interval from ICG injection to surgery was 38.3 h (range, 20.5–50.3 h). The median tumor size was 36.5 mm (range, 2–132 mm). According to the pathologic finding, the median safety margin was secured for 6 mm (range, 0–11 mm) and there was no residual finding at the liver at the follow-up computed tomography (CT).Conclusions: ICG fluorescence imaging in children with HB was feasible and safe for tumor demarcation and enhancing the accuracy of radical tumor resection.

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Intermittent ischemia enhances the uptake of indocyanine green to livers subject to ischemia and reperfusion

Abstract: It is concluded that intermittent ischemia promotes post reperfusion bile flow in the early phase of ischemia reperfusion injury principally by enhancing the movement of bile acids from the blood to hepatocytes.

Cited by 3 publications

References 28 publications

A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

Protective Efficiency Comparison of Direct and Remote Ischemic Preconditioning on Ischemia Reperfusion Injury of the Liver in Patients Undergoing Partial Hepatectomy

The Advantages of Indocyanine Green Fluorescence Imaging in Detecting and Treating Pediatric Hepatoblastoma: A Preliminary Experience

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