Table 3.
ICG and medium-term (≤3 mo) outcomes in liver transplants.
| Study | Study variable(s) | Medium-term outcome measure (n/N) | Prognostic value analysis test | Prognostic value for medium-term outcome |
|---|---|---|---|---|
| Cherchi et al.28 | Postoperative. ICG-PDR <16.0%/min on POD1 | 3-months patient survival probability | Univariate survival analysis | 3-month patient survival probability: ICG-PDR HR 13.90 (4.67–41.35), P <0.01. |
| Yunhua et al.29 | Preoperative. MELD score Postoperative. ICG-R15 on 12 h post-LT |
Early post-LT complications (11a/61) | Logistic regression | Early post-LT complications: MELD (β=0.081, P=0.097), ICG-R15 (β=0.092, P=0.005). |
| Olmedilla et al.30 | Intraoperative data. High duration of warm ischaemia time Postoperative data. Lower ICG-PDR (%/min), greater INR, greater AST (IU/l) on POD1 |
1-month mortality or re-transplantation (33a/332) | Univariate logistic regression Stepwise backward multivariate regression model |
Univariate analysis. 1-month mortality or re-transplantation: Warm ischaemia time OR 1.02 (1.01–1.04), P=0.002; ICG-PDR OR 0.83 (0.78–0.89), P <0.001; INR OR 1.57 (1.29–1.91), P <0.001; AST OR 1.02 (1.01–1.03) P <0.001. Multivariate analysis. 1-month mortality or re-transplantation: ICG-PDR OR 0.85 (0.79–0.92), P <0.001 and INR OR 1.45 (1.17–1.82), P=0.002. PF categorized: 1-month mortality or re-transplantation: ICG-PDR <10%/min OR 7.89 (3.59–17.34), P <0.001; INR ≥2.2 OR 2.91 (1.30–6.53), P=0.009. |
| Klinzing et al.31 | Preoperative. MELD score > 25, greater age, greater BMI Postoperative. ICG-PDR <20%/min within 6 h from admission to the ICU, peak bilirubin > 100 μmol/l within 7 days |
ICU stay > 4 days (27/50) Hospital stay > 37 days (13/50) |
Multivariate logistic regression model | ICU stay > 4 days: MELD score OR 4.12 (1.2–13.8), P=0.024; ICG-PDR OR 3.54 (1.1–11.8), P=0.047. Hospital stay > 37 days: MELD score OR 13 (2.5–68.6), P=0.001; ICG-PDR OR 4.67 (1.20–18.34), P=0.027; Bilirubin OR 0.063 (0.007–0.54), P=0.01. PF combined: ICU stay > 4 days: MELD score/ICG-PDR combination; BMI OR 9.61 (1.88–26.5), P=0.007. Hospital stay >37 days: MELD score/ICG-PDR combination OR 64.17 (3.3–1253), P=0.006; Age OR 22.63 (1.08–415.2), P=0.045. |
| Tsubono et al.33 | Postoperative. lower KICG-B, lower KICG-F, total bil, highest PT, highest AST, Highest ALT. | ICU stay > 7 days (30/50) Hospital stay > 30 days (29/50) Prolonged graft dysfunction (15/50) Preservation injury (20/50) Sepsis (12/50) |
Univariate and forward stepwise multivariate analysis | Univariate analysis. ICU stay > 7 days: KICG-B on POD 3,7; KICG-F on POD 3,7; P <0.01. Hospital stay > 30 d: KICG-B on POD1,3,7; KICG-F on POD1,3,7; P <0.01. Prolonged graft dysfunction: KICG-B on POD7; KICG-F on POD7; T. Bil on POD3, 7; P <0.01. Preservation injury: KICG-B on POD 1, 3, 7; KICG-F on POD 1, 3, 7; T. Bil on POD 3, 7; highest AST highest ALT; highest PT; P <0.01. Sepsis: KICG-B on POD 1, 3, 7; KICG-F on POD 1, 3, 7; T. Bil on POD 3, 7; P <0.01. Multivariate analysis. ICU stay > 7 days: KICG-F on POD 7, P=0.004. Hospital stay > 30 days: KICG-F on POD 7, P <0.0001. Prolonged graft dysfunction: T. Bil on POD7, P=0.0001. Preservation injury: KICG-F on POD3, P <0.0001; Highest ALT, P=0.0004. Sepsis: KICG-B on POD7, P=0.0001 |
ALT, alanine aminotransferase; AST, aspartate aminotransferase; Bil., Bilirubin; HR, hazard ratio; ICG-PDR, indocyanine green plasma disappearance rate; ICG-R15, ICG retention rate at 15 min; INR, international normalized ratio; KICG-B, measurement by spectrophotometric method; KICG-F, measurement by finger-piece method; MELD, Model for End-Stage Liver Disease; OR, odd ratio; POD, postoperative day.
11: 3 cases of primary non-function (PNF), or graft failure within 14 days; 2 cases of acute rejection; 4 cases of early ischaemic biliary complications within a year; 2 cases of hepatic artery thrombosis (HAT).
33: 25 cases of re-transplantation within the first 7 days. 5 of the 25 patients who underwent re-transplantation died within the first month after surgery. The reason for re-transplantation was hepatic artery thrombosis (HAT) in 14 cases, severe graft dysfunction in 10 cases, and graft infection in 1 case. 8 cases of death within the first month. The causes of death were severe graft dysfunction (7 patients), arterial thrombosis (5 patients), and pulmonary embolism (1 patient).