Indocyanine Green Clearance Correlates With Biomarkers Reflecting Key Disease‐Driving Mechanisms in Advanced Chronic Liver Disease and Predicts Acute‐on‐Chronic Liver Failure and Death

作者：Mathias Jachs, Tânia Carvalho, Benedikt Simbrunner, Georg Semmler, Lukas Hartl, Lorenz Balcar, Benedikt Hofer, Paul Thöne, Nina Dominik, Georg Kramer, Christian Sebesta, Michael Schwarz, David Bauer, Albert Friedrich Stättermayer, Matthias Pinter, Michael Trauner, Thomas Reiberger, Mattias Mandorfer · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2025 · DOI：10.1111/apt.70447 · 被引用次数：3 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Organ Transplantation Techniques and Outcomes

BACKGROUND: Indocyanine green (ICG) clearance, determined by venous sampling, has shown promising results in the diagnosis of clinically significant portal hypertension (CSPH) in compensated advanced chronic liver disease (cACLD) and prognostication in decompensated ACLD (decompensated cirrhosis). Data on ICG clearance measurement by pulse dye densitometry (PDD) via finger clip are comparatively scarce. AIMS: To evaluate the diagnostic (CSPH) and prognostic utility of ICG clearance throughout ACLD stages. METHODS: ACLD (liver stiffness ≥ 10 kPa) patients undergoing same-day hepatic venous pressure gradient (HVPG) measurement and ICG clearance assessment via PDD in 2017-2022 were recruited from the prospective Vienna Cirrhosis Study (VICIS, NCT03267615). RESULTS: Two hundred and sixty-one ACLD patients (cACLD: n = 115, decompensated cirrhosis: n = 146) were included. Among cACLD patients (CSPH: 62.4%), ICG retention 15 min (ICG-R15) correlated moderately with HVPG (Spearman's rho:0.458; p < 0.001) and yielded a suboptimal diagnostic accuracy for CSPH (AUROC: 0.687 [95% CI: 0.585-0.789]). ICG-R15 showed a strong correlation with the model for end-stage liver disease score (rho: 0.701; p < 0.001) and correlated with biomarkers of endothelial dysfunction (von Willebrand factor), systemic inflammation (C-reactive protein, procalcitonin, interleukin 6) and extracellular matrix remodelling (enhanced liver fibrosis test). In decompensated cirrhosis, ICG-R15 additionally correlated wi...