Near-infrared fluorescence imaging with indocyanine green for assessment of donor livers in a rat model of ischemia–reperfusion

Abstract

Background Although marginal donor livers expand the donor pool, an ideal method for quantitatively evaluating the quality of donor livers has not been developed. This study aimed to explore the feasibility of indocyanine green (ICG) fluorescence imaging for estimating liver function in an ischemia–reperfusion model. Methods Forty-eight rats were randomly and evenly divided into 8 groups: the control group and the experimental groups (I-VII). The portal vein blocking period was 0 min, 10 min, 20 min, 30 min, 40 min, 50 min and 60 min. After blood flow was reestablished and the hemodynamics stabilized, ICG was injected through the dorsal penile vein as a bolus, and the fluorescence signal was recorded for 30 min in real time. The fluorescence intensity (FI) curve of the liver was fitted with an asymptotic regression model. Fresh liver tissues and serum were obtained from the middle lobe of the liver on postoperative day (POD) 1 and POD 7 for histopathological evaluation and liver function tests. Results The growth rate of the FI curve, parameter b3, decreased from groups I to VII. According to the two sudden changes in b3 (20 min, 50 min), the experimental groups could be classified into 3 groups (A, B and C). Hepatocytes in groups I-II showed slight edema, group III began to show obvious hepatocyte edema and vacuolar degeneration, and in groups VI-VII, severe hepatocyte degeneration, necrosis and large inflammatory cell infiltration were observed. Suzuki’s scores in the 3 groups were also significantly different (P < 0.01). At the same time, the serum liver function in the experimental groups showed a significant increase on POD 1 and a decrease on POD 7. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB) levels of groups A, B, and C were significantly different on POD 1 (P < 0.05), and the ALT and direct bilirubin (DB) levels were significantly different on POD 7 (P < 0.05); the lactic dehydrogenase (LDH) level of the group C was significantly higher than that of the groups A and B on POD 1 and POD 7. Meanwhile, the 7-day survival rate of the rats in group C was poor compared to that of the rats in groups A and B (58.3% vs. 100% vs. 100%). Conclusion ICG fluorescence imaging is effective for estimating the degree of liver damage and grading in an ischemia–reperfusion model. It probably has the potential for use in assessing the quality of the donor liver in liver transplantation.

A bibliometric analysis of indocyanine green (ICG) in hepatobiliary surgery from 2008 to 2021

“…The application of ICG in LT and cancer-targeted fluorescence molecular imaging still requires a pilot study. Timeline visualization maps showing that liver function is related to recovery and protection [ 43 , 44 ] may be a trend of future research. Our research shows that the application of the ICG in determining LT survival and prognosis is currently the main research focus, and we anticipate breakthroughs in this field soon.…”

Cannabidiol may prevent the development of congestive hepatopathy secondary to right ventricular hypertrophy associated with pulmonary hypertension in rats

“…Histopathological changes of each liver section (5 sections per each animal ( n = 5–6)) were blindly evaluated in ≥ 10 randomly selected non-overlapping fields using an Olympus BX43 (Olympus 114 Corp., Tokyo, Japan) microscope equipped with an Olympus DP12 camera at 200× magnifications. In each liver sample, the percentage area of sinusoidal congestion, necrosis, and vacuolization was assessed with the ImageJ software version 1.53c (NIH, Bethesda, MD, USA) using Suzuki’s classification according to the following criteria [ 22 ]:…”