Non-invasive ICG-clearance: a useful tool for the management of hepatic artery thrombosis following liver transplantation

作者：Levesque E; Hoti E; Azoulay D; Adam R; Samuel D; Castaing D; Saliba F^*

来源：Clinical Transplantation, 2011, 25(2): 297-301.

DOI：10.1111/j.1399-0012.2010.01252.x

• complication
• hepatic artery thrombosis
• indocyanine green
• LiMON
• liver transplantation

Background:
The clinical presentation of hepatic artery thrombosis (HAT) post-liver transplantation (LT) varies considerably. Doppler ultrasonography (Doppler US) is the first line investigation, with a diagnostic sensitivity for HAT as high as 92%. Because indocyanine green (ICG) elimination from the blood depends among other factors on the hepatic blood flow, we hypothesized that plasma disappearance rate of indocyanine green (PDR-ICG) can be influenced by the flow in the hepatic artery. Thus, we evaluated the role of PDR-ICG measurement in HAT diagnosis in post-LT patients.
Patients and methods:
Fourteen liver transplant patients with no visible flow in the hepatic artery (Doppler US) were identified. Of the 14, seven patients had HAT confirmed by CT-angiography. The PDR-ICG measurement, an investigation routinely used in our center, was performed in all 14 patients.
Results:
The PDR-ICG in patients with HAT was significantly lower than in patients without HAT (5.8 +/- 4.3 vs. 23.8 +/- 7.4%/min, p = 0.0009). In patients with HAT, after the revascularization, the PDR-ICG value increased (5.8 +/- 4.3 vs. 15.6 +/- 3.5%/min, p = 0.006).
Conclusion:
The ICG elimination may be an adjunct diagnostic tool in the management of patients with suspected HAT following LT.

• 出版日期2011-4