Indocyanine Green Clearance Test in Liver Transplantation (LivInG)

Summary

The gap between patients awaiting and those undergoing liver transplantation (LT) continues to grow. Marginal organs carry higher risk of failure after LT however they are increasingly used to fill such gap. Viability assessment of the graft is essential to lower the risk of LT failure and need for emergency re-LT, however this still relies mainly on surgeon's experience. Post-LT graft function recovery assessment is also essential to aid physicians in the management of LT recipients and guide them through challenging decision-making. With the present study we aim to validate the use of indocyanine green clearance test (IGT) in two settings: in the donor as an objective tool to assess graft viability; in the recipient to assess graft function recovery after LT. The implementation of IGT in routine practice translates into two main advantages: to avoid using grafts with no chance of recovery and to optimize resource allocation to LT recipients depending on their graft function recovery.

Timeline

Start

2022-02-01

Primary completion

2024-09-01

Completion

2024-11-01

Publications

• Background Lo IJ, Lefkowitch JH, Feirt N, Alkofer B, Kin C, Samstein B, Guarrera JV, Renz JF. Utility of liver allograft biopsy obtained at procurement. Liver Transpl. 2008 May;14(5):639-46. doi: 10.1002/lt.21419.
• Background Levesque E, Martin E, Dudau D, Lim C, Dhonneur G, Azoulay D. Current use and perspective of indocyanine green clearance in liver diseases. Anaesth Crit Care Pain Med. 2016 Feb;35(1):49-57. doi: 10.1016/j.accpm.2015.06.006. Epub 2015 Oct 21.
• Background Lau H, Man K, Fan ST, Yu WC, Lo CM, Wong J. Evaluation of preoperative hepatic function in patients with hepatocellular carcinoma undergoing hepatectomy. Br J Surg. 1997 Sep;84(9):1255-9.
• Background Wang W, Zhao Q, Hu A, He X, Zhu X. Application of Indocyanine Green (ICG) Detection in Evaluating Early Prognosis in Patients with Fatty Liver Disease After Liver Transplantation. Ann Transplant. 2017 Apr 11;22:208-214. doi: 10.12659/aot.901277.
• Background Tang Y, Han M, Chen M, Wang X, Ji F, Zhao Q, Zhang Z, Ju W, Wang D, Guo Z, He X. Donor Indocyanine Green Clearance Test Predicts Graft Quality and Early Graft Prognosis After Liver Transplantation. Dig Dis Sci. 2017 Nov;62(11):3212-3220. doi: 10.1007/s10620-017-4765-x. Epub 2017 Sep 20.
• Background Levesque E, Saliba F, Benhamida S, Ichai P, Azoulay D, Adam R, Castaing D, Samuel D. Plasma disappearance rate of indocyanine green: a tool to evaluate early graft outcome after liver transplantation. Liver Transpl. 2009 Oct;15(10):1358-64. doi: 10.1002/lt.21805.
• Background Schneider L, Spiegel M, Latanowicz S, Weigand MA, Schmidt J, Werner J, Stremmel W, Eisenbach C. Noninvasive indocyanine green plasma disappearance rate predicts early complications, graft failure or death after liver transplantation. Hepatobiliary Pancreat Dis Int. 2011 Aug;10(4):362-8. doi: 10.1016/s1499-3872(11)60061-1.
• Background Imamura H, Sano K, Sugawara Y, Kokudo N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg. 2005;12(1):16-22. doi: 10.1007/s00534-004-0965-9.
• Background Olthoff KM, Kulik L, Samstein B, Kaminski M, Abecassis M, Emond J, Shaked A, Christie JD. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl. 2010 Aug;16(8):943-9. doi: 10.1002/lt.22091.
• Coppola A, Bianco G, Lai Q, Marrone G, Caimano M, Agnes S, Spoletini G. Indocyanine green clearance test in liver transplantation: defining cut-off levels for graft viability assessment during organ retrieval and for the prediction of post-transplant graft function recovery - the Liver Indocyanine Green (LivInG) Trial Study Protocol. BMJ Open. 2022 Aug 1;12(8):e063081. doi: 10.1136/bmjopen-2022-063081.

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