Determination of hepatic clearance by derivations of the indocyanine green retention test in cirrhosis

• Published in: Journal of gastroenterology and hepatology 2022-04, Vol.37 (4), p.692-699
• Main Authors: Møller, Søren, Henriksen, Jens H., Sjöstedt, Sannia, Bendtsen, Flemming
• Format: Article
• Language: English
• Subjects: Ascites; Cirrhosis; Esophageal and Gastric Varices - diagnosis; Esophageal and Gastric Varices - etiology; Esophagus; Excretory dysfunction; Hemodynamics; Hepatic dye uptake; Hepatocytes; Humans; Hypertension, Portal; Indocyanine Green; Indocyanine green‐clearance; Injection; Liver; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver diseases; Liver failure; Liver Function Tests; Male; Plasma
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.15778

Background and Aim The study was undertaken in order to compare single injection indocyanine green (ICG)‐clearances with the steady‐state ICG‐clearance (ICGCl) in patients with cirrhosis in order to assess the most accurate estimate for ICG‐clearance and to relate the ICG‐clearances to established indicators of liver dysfunction. Methods Thirty‐eight patients (male 29) with cirrhosis (Child–Turcotte class A 8, class B 21, and class C 9) were studied during a hemodynamic investigation. A single injection of ICG was followed by blood samples for 5, 10, 15, and 20 min. The dose/plasma area clearance (ClA) and plasma volume · initial slope clearance (ClPV) were determined and compared with the steady‐state infusion/plasma concentration ratio clearance (ICGCl). Results The ClA (310; 214; 502 mL/min) and ClPV (294; 164; 481 mL/min) correlated closely with ICGCl (243; 120; 383 mL/min [median; interquartile range], R = 0.95–0.98, P