Hepatic parenchymal cell volume and the indocyanine green tolerance test.

BACKGROUND Precise evaluation of the hepatic function of preoperative patients with liver cirrhosis is controversial. Hepatic functional capacity cannot be evaluated easily because hepatic function is not based on morphological aspects. PURPOSE The aim of this study was to evaluate hepatic function with a new procedure of the indocyanine green (ICG) tolerance test using an ICG clearance meter, and to compare liver parenchymal cell volume with hepatic function. PATIENTS AND METHODS Sixteen patients (seven with histologically normal liver and nine with histologically proven liver cirrhosis) scheduled for liver resection were selected randomly for the study. Measurement of two blood disappearance rate constants of ICG, k(100-900) and k(100-300), and effective hepatic blood flow (EHBF) using an ICG clearance meter, as well as conventional ICG-k(5,10,15) and ICG-R15, was performed. We calculated k(100-300) and EHBF using the early disappearance rate of ICG with the ICG clearance meter. Liver parenchymal cell volume was measured using CT volume and the liver parenchymal cell ratio with computer-aided image analysis. RESULTS The value of ICG-k(100-300) was mostly proportional to liver parenchymal cell volume. EHBF per liver parenchymal cell volume did not differ between normal and cirrhotic subjects. CONCLUSIONS ICG-k(100-300) and EHBF are good indices of liver function and are proportional to liver parenchymal cell volume. Hepatic dysfunction in cirrhosis is due to a decrease in liver parenchymal cell volume.

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