Dataset Information

Advantages of using indocyanine green in liver transplantation: a narrative review.

ABSTRACT:

Objective

To assess the role of indocyanine green in liver transplantation and to lay the foundation for its application in clinical practice.

Background

Liver transplantation offers the best prognosis for patients with end-stage liver disease. However, this invasive procedure involves multiple well-known challenges, including complications due to graft rejection and dysfunction, surgical risks, and critical postoperative management. Intraoperative methods to assess graft function rely on conventional methods, such as blood chemistries and Doppler ultrasound. However, these methods are limited in their abilities to assess liver conditions, predict functional outcomes of the graft, and prevent surgical complications. Thus, identifying a more effective and comprehensive detection method is necessary.

Methods

The information used to write this narrative review was collected from the references' opinions and conclusions.

Conclusions

Indocyanine green can effectively monitor blood flow during surgery, evaluate donor graft function, and monitor the recipients functional status during and after surgery. It may also help surgeons to predict the prognosis of patients throughout the liver transplantation process, from assessing patients for liver transplantation status to postoperative management. Therefore indocyanine green should be routinely used in liver transplantation to help re-organize the transplant waiting list and improve the surgical outcomes of liver transplantation patients.

SUBMITTER: Dai B

PROVIDER: S-EPMC8848388 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Advantages of using indocyanine green in liver transplantation: a narrative review.

Dai Bo B Guissi Nida El Islem NEI Sulyok Lydia Frenzel LF Bryski Mitchell G MG Wang Yiqing Y Wang Dongjin D Singhal Sunil S Cai Huiming H

Annals of translational medicine 20220101 2

<h4>Objective</h4>To assess the role of indocyanine green in liver transplantation and to lay the foundation for its application in clinical practice.<h4>Background</h4>Liver transplantation offers the best prognosis for patients with end-stage liver disease. However, this invasive procedure involves multiple well-known challenges, including complications due to graft rejection and dysfunction, surgical risks, and critical postoperative management. Intraoperative methods to assess graft function ...[more]

PMID: 35282122

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Project description:Background and objectiveThe early detection and early treatment of high-risk pulmonary nodules directly affect the long-term survival rate of patients. However, conventional nodule localization methods, such as hook-wire, technetium-99m, and methylene blue are associated with issues such as a high-frequency of complications, low patient tolerance, serious side effects, and inability to identify pigmented lungs. For patients who require segmentectomy, there is often a lack of effective path planning, resulting in insufficient resection margins or excessive loss of lung function. Therefore, effective and rational nodule localization and surgical approaches are crucial. This narrative review aimed to evaluate the advantages of indocyanine green (ICG) fluorescence in pulmonary nodule surgery and clarify its application in various types of patients.MethodsWe searched the PubMed and Web of Science databases from January 2010 to January 2024 using the terms "localization of pulmonary nodules", "localization of pulmonary nodules AND indocyanine green", "localization of pulmonary nodules AND complication", "localization of pulmonary nodules AND surgical planning", and "localization of pulmonary nodules AND underlying lung disease". Information used to write this narrative review was from clinical phenomena, statistical data, and authors' conclusions.Key content and findingsThe commonly used localization methods of pulmonary nodule such as computed tomography (CT)-guided percutaneous placement of hook-wire are accompanied with serious complications: including hemopneumothorax and ache. Meanwhile, routine dye commonly fails to localize the nodules in patients with anthracosis. ICG with the enhanced permeability and retention (EPR) effect can be used effectively for preoperative and intraoperative localization of pulmonary nodules and its nature of allowing the observance of the condition of pulmonary blood vessels has gradually become a hotspot of research in this field.ConclusionsFor nodules with a depth of less than 1 cm, no penetration depth problem is encountered when ICG fluorescence is used. Percutaneous puncture can effectively identify the location of nodules at low cost. Compared with other localization methods, it can effectively avoid problems such as pain, radiation exposure, marker displacement, and the existence of anthrax lesions in the lungs. For patients on whom it is difficult to locate nodules due to tissue results, virtual bronchoscopy or electromagnetic navigation bronchoscopy can effectively identify nodules and reduce complications such as pneumothorax. For patients whose operation is postponed due to fever, sudden cardiovascular and cerebrovascular diseases, there is no risk of nodule localization material detachment by using ICG. ICG can also be used in patients with pulmonary physiological or pathological diseases. Meanwhile, in patients with deep pulmonary nodules, ICG fluorescence can help plan the surgical path, ensure the margin of resection, reduce lung function damage, and prevent bronchial fistula. Therefore, the rational use of ICG fluorescence technology can effectively locate nodules, assist surgeons in planning surgical methods, potentially reducing complications and ultimately improving patient prognosis.

Project description:BackgroundLiver transplantation (LT) is the gold standard for end-stage liver disease, yet postoperative complications challenge patients and physicians. Indocyanine green (ICG) clearance, a quantitative dynamic test of liver function, is a rapid, reproducible, and reliable test of liver function. This study aimed to systematically review and summarize current literature analyzing the association between ICG tests and post-LT outcomes.MethodsThis systematic review was conducted according to PRISMA guidelines. MEDLINE and Cochrane Library, as main databases, and other sources were searched until August 2022 to identify articles reporting the prognostic value of postoperative ICG tests associated with outcomes of adult LT recipients.Risk of bias (ROB) of included articles was assessed using Quality In Prognosis Studies tool. Methodological quality varied from low to high across ROB domains.ResultsSix studies conducted between 1994 and 2018 in Europe, America, and Asia were included. The study population ranged from 50 to 332 participants. ICG clearance on the first postoperative day was associated with early allograft dysfunction (EAD), graft loss, 1- and 3-mo patient survival probability, prolonged intensive care unit (ICU), and hospital stay. The dichotomized ICG plasma disappearance rate (PDR) provided a strong association with medium- and long-term outcomes: PDR<10%/min with 1-month mortality or re-transplantation (Odds Ratio (OR): 7.89, 95% confidence interval (CI) 3.59-17.34, P<0.001) and PDR<16.0%/min with 3-month patient survival probability (Hazard ratio (HR): 13.90, 95% CI 4.67-41.35, P<0.01). The preoperative model for end-stage liver disease and body mass index were independent prognostic factors for EAD, early complications, and prolonged ICU stay; post-LT prothrombin time and INR were independently associated with graft loss and bilirubin with a prolonged hospital stay.ConclusionThis review shows that ICG clearance tests are associated with graft function recovery, suggesting that a potential prognostic role of ICG test, as an aid in predicting the post-LT course, could be considered.

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Project description:Background and objectiveAs a surgical tool, indocyanine green (ICG) is increasingly used in surgery, especially in gastric and colorectal surgery. The use of ICG fluorescence imaging can improve the accuracy of tumor resection and potentially improve surgical outcomes for cancer patients. However, there are still different opinions or controversies on the application of ICG in the literature and the administration of ICG is still not uniform. In this review, we summarize the current status of its application and ICG administration methods in gastrointestinal cancer and discuss its existing limitations and future research directions.MethodsLiterature published in the PubMed database from 1969 to 2022 was searched for using the keywords "Indocyanine green or near-infrared imaging or ICG", "gastric cancer", "gastroesophageal junction cancer", and "colorectal cancer" to summarize the main applications of ICG in gastrointestinal cancers.Key content and findingsICG guidance can rapidly determine tumor location and save operative time, and can also visualize lymph nodes (LNs) in real-time, helping surgeons to retrieve more LNs for better postoperative staging, but its use in identifying sentinel lymph node (SLN) in gastric cancer (GC) remains controversial due to false negatives. ICG fluorescent angiography has great potential in preventing colorectal anastomotic leakage, but there is a dearth of high-caliber research evidence. In addition, ICG has unique advantages in detecting colorectal liver micrometastasis. Notably, there is still no uniform administration method and dose of ICG.ConclusionsIn this review, we summarize the current status of ICG application in gastrointestinal cancer, and the current literature suggests that it is safe and effective and has the potential to change the clinical outcome of patients. Therefore, ICG should be routinely used in gastrointestinal cancers to improve the surgical outcomes of patients. In addition, this review summarizes the ICG administration in the literature, and we expect future guidelines to unitize and standardize the administration of ICG.

Dataset Information

Advantages of using indocyanine green in liver transplantation: a narrative review.

Objective

Background

Methods

Conclusions

Publications

Advantages of using indocyanine green in liver transplantation: a narrative review.

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