Prognostic value of hepatic clearance of indocyanine green (ICG) in cirrhotic patients who have bled from oesophageal varices

Navasa, Miguel; García-Pagán, JC; Feu, Faust; Terés, Josep; Bosch, J.; Rodés, Juan

doi:10.1016/0168-8278(89)90566-7

Cited by 4 publications

(5 citation statements)

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“…(11) Indocianine green clearance, extraction index, and hepatic blood flow were measured in a subgroup of 23 patients, included in two of the participating centers, as described. (12) (see Supporting Methods).…”

Section: Clinical and Laboratory Datamentioning

confidence: 99%

Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The SportDiet study

et al. 2017

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Obesity increases the risk of clinical decompensation in cirrhosis, possibly by increasing portal pressure. Whether weight reduction can be safely achieved through lifestyle changes (diet and exercise) in overweight/obese patients with cirrhosis, and if weight loss reducesportal pressure in this setting is unknown. This prospective, multicentric, uncontrolled pilot study enrolled patients with compensated cirrhosis, portal hypertension (hepatic venous pressure gradient, HVPG≥ 6mmHg) and body mass index (BMI)≥26 Kg/m2 in an intensive 16-week lifestyle intervention program (personalized hypocaloric normoproteic diet and 60 min/wk of supervised physical activity). We measured HVPG, body weight and composition, adipokines, health-related quality-oflife and safety data prior and after the intervention. Changes in HVPG and body weight were pre-defined as clinically relevant if ≥10% and ≥5%, respectively. Safety and body weight were re-assessed after 6 months. 60 patients were included and 50 completed the study (56±8 y/o; 62% male; NASH etiology 24%; BMI 33.3±3.2Kg/m2; Child A 92%; HVPG ≥10 mmHg 72%). Lifestyle intervention significantly decreased body weight (average -5.0±4.0 Kg; p<0.0001), by ≥ 5% in 52% and ≥10% in 16%. HVPG also significantly decreased (from 13.9±5.6 mmHg to 12.3±5.2 mmHg, p<0.0001), by ≥10% in 42% and ≥20% in 24%. A ≥10% body weight loss was associated with a greater decrease in HVPG (-23.7±19.9% vs. -8.2±16.6%,p=0.024). No episodes of clinical decompensation occurred. Weight loss achieved at 16-wks was maintained at 6-month;Child and MELD scores did not change.Conclusions. 16-weeks of diet and moderate exercise were safe and reduced body weight and portal pressure in overweight/obese patients with cirrhosis and portal hypertension.

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Section: Clinical and Laboratory Datamentioning

confidence: 99%

Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The SportDiet study

et al. 2017

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“…In a heterogeneous group of patients with various etiologies of liver disease, a significant correlation of QTLF (ABT, GEC, MegX, Caffeine) with the Child‐Pugh score was found by several authors (32–35). We could show reasonable correlations of the four QTLF (>0.5) in all cirrhotic patients and in patients with cirrhosis CP grade A (except for the pairs ABT/SCl and ICG/SCl).…”

Section: Discussionmentioning

confidence: 92%

Quantitative testing of liver function in patients with cirrhosis due to chronic hepatitis C to assess disease severity

Herold¹,

Heinz²,

Radespiel‐Tröger

et al. 2001

Liver

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“…Therefore, ICG may also be an indirect indicator of portal hypertension and EV in cirrhosis. As early as 1992, Navasa et al [21] found that hepatic ICG clearance was of some value in predicting the development of EV. Lisotti et al [15] used HVPG and endoscopy as the gold standard and found that ICG-R15 and INR were independently associated with EV, with ICG-r15 less than 10% having a higher sensitivity for excluding EV and severe EV and identifying patients with EV.…”

Section: Discussionmentioning

confidence: 99%

“…As early as 1992, Navasa et al . [21] found that hepatic ICG clearance was of some value in predicting the development of EV. Lisotti et al .…”

Section: Discussionmentioning

confidence: 99%

Noninvasive diagnostic value of indocyanine green retention test in patients with esophagogastric varices in liver cirrhosis

Zhou

Lin

Pan

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Objective This study aimed to evaluate the value of the indocyanine green retention test (ICG-R15) as a noninvasive predictor of gastroesophageal varices (GOV) in cirrhosis. Methods A total of 629 patients with cirrhosis who were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University between June 2016 and September 2020 (450 in the trial group and 179 in the validation group) were selected. The trial group was divided into a GOV group and a non-GOV group based on gastroscopic findings. The two group's ICG results, clinical hematological, biochemical, and ultrasound parameters were compared. A predictive model for the noninvasive diagnosis of GOV was developed by applying binary logistic regression analysis and compared with previous common noninvasive diagnostic methods, followed by model validation in a validation group. Results ICG-R15 is positively correlated with the degree of varicose veins. Univariate and multifactorial logistic regression analyses showed that PLT, PT, ICG-R15, splenic length, splenic vein diameter, and the presence of ascites were independent predictors of GOV. Predictive equation 1 for GOV was constructed based on the above factors: Logistic (Y1) = 1.327 × PLT + 0.691 × PT + 1.110 × ICG-R15 + 0.581 × SVD + 0.815 × SD + 1.130 × presence of ascites − 2.133, which predicted GOV in cirrhosis with an AUC of 0.861, sensitivity 84.5%, and specificity 74.1%. As the internal diameter of the splenic vein and the long diameter of the spleen are influenced by subjective factors and data are not easily available, we removed these two factors and constructed the prediction equation logistic (Y2) = 1.516 × PLT + 0.856 × PT + 1.135 × R15 + 1.297 × presence of ascites − 1.513. AUC for predicting GOV was also high at 0.850, with a sensitivity of 75.3% and a specificity of 83.2%. Similar results were obtained in the validation group. However, the previous GOV prediction models ARPI, AAR, FIB-4, Lok, FI, and King had AUCs of 0.731, 0.643, 0.781, 0.763, 0.735, and 0.730, respectively, in our trial group, with only low-tomoderate diagnostic efficacy. Conclusion ICG-R15 correlates with the severity of GOV in cirrhosis, and the models based on it can further improve the noninvasive diagnostic efficacy of GOV.

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Prognostic value of hepatic clearance of indocyanine green (ICG) in cirrhotic patients who have bled from oesophageal varices

Cited by 4 publications

References 0 publications

Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The SportDiet study

Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The SportDiet study

Quantitative testing of liver function in patients with cirrhosis due to chronic hepatitis C to assess disease severity

Noninvasive diagnostic value of indocyanine green retention test in patients with esophagogastric varices in liver cirrhosis

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