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|Title:||Indocyanine green clearance is a useful tool for assessing brain dead donor liver function.|
|Authors:||Lau, Lawrence F;Jones, Robert M;Riddiough, Georgina E;Starkey, Graham M;Fink, Michael A;Wang, Bao-Zhong;Christophi, Christopher;Lokan, Julie;asadi, Khashyar;Muralidharan, Vijayaragavan|
|Affiliation:||Department of Surgery, Austin Health, Heidelberg, Victoria, Australia|
|Abstract:||Objectives: Donor liver quality is a critical factor which determines outcome following liver transplantation. Current assessment is largely subjective. This study aims to assess the feasibility and use of indocyanine green clearance (ICG) in the objective quantification of donor liver function for transplantation. Methods: Potential brain-dead liver donors were recruited. ICG clearance was performed prior to organ retrieval and compared to histopathology, surgeon assessment of macrosteatosis and donor risk index (DRI). Primary outcome parameters were early allograft dysfunction and post-operative mortality. Results: Fifteen brain dead donors were recruited for this study. There were three patients with early allograft dysfunction and one post-operative mortality following a prolonged 70 day ICU stay. In the patient that died, the ICG clearance of the donor liver at the time of organ retrieval was significantly lower compared to the other donor livers (9 vs. median 28.5, range 17.1-46.3%/min). Correspondingly, the DRI was also the lowest in this donor (2.1 vs. median 1.53, range 1.1-2.0). Surgeon assessment and degree of macrosteatosis on histopathological examination did not predict to outcome. Conclusion: ICG assessment of donor liver function is feasible and practical. It may be incorporated with little interruption into the current organ retrieval process and provides an objective quantification of donor liver function. There is early evidence that this is better than surgeon macroscopic or histological assessment and may be a useful adjunct to the DRI. Further studies are required to establish an ideal cut-off level for its use in donor liver assessment for transplantation.|
|Conference Name:||HPB. Conference: 5th Biennial Congress of the Asian-Pacific Hepato-Pancreato-Biliary Association.|
|Conference Location:||Singapore, Singapore|
|Appears in Collections:||Conference presentations|
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