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Predicting successful outcomes in living-donor liver transplants

ical outcomes. ICG was injected into the patients and its disappearance was monitored by a non-invasive photometric device. This was done for the first 14 days following transplant (including every 12 hours in the first 72 hours) and again at 21 and 28 days following surgery.

The results showed that immediately following transplant, elimination of ICG improved for all patients in the study when compared to pre-operative tests, but within 24 hours ICG elimination was significantly better in Group I than in Group II. The test correlated well with more traditional methods of measuring liver function, specifically liver biopsies that were performed in 17 of the patients and liver scintigraphy (an imaging technique using a radioactive substance that is swallowed) performed on 18 patients. The ICG test however, had certain benefits. "This novel noninvasive method has advantages in its simplicity, its real-time presentation of results without consuming a lot of time, and its cost-effectiveness," the researchers note. They conclude that being able to predict poor outcomes based on ICG elimination immediately following liver transplants should have a large impact on further improving LDLT outcomes, since appropriate clinical management can then be instituted if necessary.

In another study in the same issue, researchers led by Christoph Jochum, M.D. of the University Duisberg-Essen in Essen, Germany investigated ICG elimination, galactose elimination capacity (GEC), and lidocaine elimination as markers for the quality of liver regeneration in 22 donors and their recipients in the first 3 months following LDLT. They found that ICG elimination and GEC remained significantly altered in donors and improved significantly in recipients during that period, while lidocaine elimination showed no significant changes. "In this study we evaluated only a small group of patients, however the results indicate a longer and more profound change in the quality of the liver of d
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Source:John Wiley & Sons, Inc.


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