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- Title
Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation.
- Authors
Vos, J.; Scheeren, T.; Lukes, D.; Boer, M.; Hendriks, H.; Wietasch, J.
- Abstract
Early postoperative complications after orthotopic liver transplantation (OLT) are a common problem in intensive care medicine. Adequate assessment of initial graft function remains difficult, however, plasma disaperance rate of indocyanine green (PDR) may have an additional diagnostic and prognostic value in this setting. We retrospectively evaluated the ability of intraoperative PDR values to predict absence of early postoperative complications in 62 subjects. PDR was measured non-invasively by pulse dye densitometry during surgery and was correlated with initial graft function. At the end of surgery, PDR was higher in patients without complications: 24.9 % min (n = 40) versus 21.0 % min, (n = 22; p = 0.034). An area under the ROC curve (AUROC) for PDR was 0.70, while the AUROC for pH, lactate and PT at ICU admission were 0.53, 0.50 and 0.46, respectively. The AUROC of serum bilirubin and PT at postoperative day 5 were 0.68 and 0.49, respectively. The optimal cut-off PDR value for predicting absence of development early postoperative complications was determined to be 23.5 % min with 72.4 % sensitivity and 71.0 % specificity. Intraoperative point-of-care PDR measurement during OLT already predicts absence of early postoperative complications, better and earlier than clinically used laboratory parameters.
- Subjects
AUTOGRAFTS; INDICATOR dilution; ICGS (Electronic computer system); LIVER transplantation; HYPERBILIRUBINEMIA; POLYCYCLIC compounds
- Publication
Journal of Clinical Monitoring & Computing, 2013, Vol 27, Issue 5, p591
- ISSN
1387-1307
- Publication type
Article
- DOI
10.1007/s10877-013-9474-1