Experimental study of liver dysfunction evaluated by direct indocyanine green clearance using near infrared spectroscopy

Background: Blood clearance of indocyanine green (ICG) is an objective test of liver function. Hepatic ICG clearance can now be measured directly usin g near infrared spectroscopy (NIRS). The aim of this study was to evaluate measurement of hepatic ICG clearance by NIBS in an animal model of acute he patic dysfunction. Methods: New Zealand white rabbits (n = 36) underwent laparotomy for liver exposure. Hepatic blood flow and microcirculation were measured along with hepatic ICG concentration by NIBS. Hepatic ICG clearance was measured in gr oups of six animals after reduction of the hepatic blood flow by hepatic ar tery occlusion and portal vein partial occlusion, lobar ischaemia and reper fusion (I/R), colchicine administration and bile duct ligation. Hepatic ICG uptake and excretion rates were calculated by a nonlinear least square cur ve fitting method from the ICG concentration-time curve. Results: There was a significant positive correlation between hepatic ICG r ate of uptake and both hepatic blood flow and microcirculation (r = 0.79, P = 0.0001; r = 0.59, P = 0.005 respectively). I/R resulted in a significant reduction of both the rates of ICG uptake (mean(s.d.) 0.85(0.59)min(-1); P = 0.0002 versus control) and ICG excretion (0.020(0.006)min(-1); P = 0.02 versus control). Colchicine decreased the rate of hepatic ICG excretion (0. 030(0.010) min(-1); P = 0.02 versus control) as did bile duct ligation (0.0 02(0.001) min(-1); P = 0.01 versus control). Conclusion: Measurement of hepatic ICG clearance by NIBS is a promising tec hnique for assessing hepatic parenchymal dysfunction and may have applicati on in liver surgery and transplantation.