Lars C Pietersen1*, Marije Reekers2, Hein Putter3, Maarten E Tushuizen4, Willemijn N Nijboer1, Ian PJ Alwayn1, Bart van Hoek4 and Andries E Braat1
1Department of Surgery, Leiden University Medical Center, The Netherlands
2Department of Anesthesiology, Leiden University Medical Center, The Netherlands
3Department of Medical Statistics, Leiden University Medical Center, The Netherlands
4Department of Gastroenterology and Hepatology, Leiden University Medical Center, The Netherlands
Background: In Liver Transplantation (LT) early detection of postoperative graft failure may facilitate timely listing for retransplantation. Unfortunately, no simple and specific early predictor of graft failure is currently available. The aim of this study was to evaluate intraoperative Indocyanine Green Plasma Disappearance Rate (ICG-PDR) directly following complete reperfusion as a predictor for Primary Non-Function (PNF) and one-month graft survival in LT. Methods: Between January 2010 and May 2017, ICG-PDR measurement was performed intraoperatively immediately following complete arterial and portal reperfusion in all orthotopic LTs performed in a single center (n=197). Results: LTs with an intraoperative ICG-PDR <18%/min had significantly lower one-month graft survival (87%), compared to LTs with intraoperative ICG-PDR ≥ 18%/min (94%) (Logrank p=0.04). Furthermore, none of the liver grafts with an intraoperative ICG-PDR ≥ 18%/min developed PNF, versus 10% of the liver grafts with an intraoperative ICG-PDR <18%/min (p<0.001). Conclusion: low intraoperative ICG-PDR (ICG-PDR <18%/min) is a significant risk-factor for one-month graft failure and primary non-function, while normal intraoperative ICG-PDR excludes PNF.
Indocyanine green; Liver transplantation; Graft survival; Primary non-function; Retransplantation
Pietersen LC, Reekers M, Putter H, Tushuizen ME, Nijboer WN, Alwayn IPJ, et al. Normal Intraoperative Indocyanine Green Plasma Disappearance Rate Excludes Primary Non-Function after Liver Transplantation. Clin Surg. 2021; 6: 3324.