Comparison of indocyanine green clearance with Child's-Pugh score and hepatic histology: a multivariate analysis
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Published on: March 17, 2023
Sandeep Mukherjee1, Mary A M Rogers, Borys Buniak
1Liver Gallbladder Pancreas Center, Section of Gastroenterology and Hepatology, Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York, USA. smukherj@unmc.edu
Background/Aims:
Indocyanine green clearance, measured by percentage disappearance rate, detects alterations in liver function and may be used as a non-invasive determinant of hepatic reserve. The aims of this study were to compare liver histology and Child's-Pugh score with percentage disappearance rate and determine which variables correlated with PDR.
Methodology:
Child's-Pugh score, liver function tests, liver biopsies and indocyanine green testing (0.5mg/kg) were performed in 102 consecutive patients with cirrhosis of diverse etiologies. Indocyanine green concentration was determined using spectrophotometric analysis (806nm) and plotted logarithmically with Michaelis-Menten kinetics to calculate the percentage disappearance rate. Liver biopsies were graded using the modified Knodell score to obtain a histological activity index.
Results:
In bivariable analysis, percentage disappearance rate significantly correlated with Child's-Pugh score, albumin, bilirubin, prothrombin time and histological activity index. Albumin, prothrombin time and histological activity index were independent predictors of percentage disappearance rate in the final model (albumin p<0.01, prothrombin time p<0.046, histological activity index p=0.033), accounting for 46.2% of variability in percentage disappearance rate measurements.
Conclusions:
Percentage disappearance rates correlated with Child's-Pugh scores in this series of cirrhotic patients. However, 46.2% of its variability was accounted for by albumin, prothrombin time and histological activity index.
