Non‐invasive ICG‐clearance: a useful tool for the management of hepatic artery thrombosis following liver transplantation

Levesque E, Hoti E, Azoulay D, Adam R, Samuel D, Castaing D, Saliba F. Non‐invasive ICG‐clearance: a useful tool for the management of hepatic artery thrombosis following liver transplantation.
Clin Transplant 2011: 25: 297–301. © 2010 John Wiley & Sons A/S. Abstract: Background: The clinical presentation of hepatic artery thrombosis (HAT) post‐liver transplantation (LT) varies considerably. Doppler ultrasonography (Doppler US) is the first line investigation, with a diagnostic sensitivity for HAT as high as 92%. Because indocyanine green (ICG) elimination from the blood depends among other factors on the hepatic blood flow, we hypothesized that plasma disappearance rate of indocyanine green (PDR‐ICG) can be influenced by the flow in the hepatic artery. Thus, we evaluated the role of PDR‐ICG measurement in HAT diagnosis in post‐LT patients. Patients and methods: Fourteen liver transplant patients with no visible flow in the hepatic artery (Doppler US) were identified. Of the 14, seven patients had HAT confirmed by CT‐angiography. The PDR‐ICG measurement, an investigation routinely used in our center, was performed in all 14 patients. Results: The PDR‐ICG in patients with HAT was significantly lower than in patients without HAT (5.8 ± 4.3 vs. 23.8 ± 7.4%/min, p = 0.0009). In patients with HAT, after the revascularization, the PDR‐ICG value increased (5.8 ± 4.3 vs. 15.6 ± 3.5%/min, p = 0.006). Conclusion: The ICG elimination may be an adjunct diagnostic tool in the management of patients with suspected HAT following LT.