Investigation of the Hepatic Excretion Mechanism of Indocyanine Green in Patients with Liver Disease

The purpose of the present paper is to clarify the disturbance of the indocyanine green (ICG) uptake-excretion mechanism in patients with liver disease. The following parameters were used to indicate the disappearance rate of various dyes from plasma; K for ICG, KAU for 198Au colloid and KRB for 131I-rose bengal. ICG was administered intravenously using three different continuous infusion rates on all patients. The maximum rate of biliary excretion (Tm) as well as the relative hepatic storage capacity (S) were determined. Tm and S definitely decreased in cases with liver cirrhosis. Tm had no relationship to the degree of liver damage, but S fell in proportion to its dysfunction. KAU and KRB significantly decreased in cases of liver cirrhosis, while chronic aggressive hepatitis revealed a marked decrease of Krb without an equivalent decrease of KAU. The correlation coefficient between K and S was definitely higher than that between K and Tm, and K was more closely correlated with KRB than KAU. From these results, it was reasonable to presume that K was more influenced by the hepatic uptake and storage than by the excretion of ICG in the bile, and indicated that the capacity of the liver to handle dyes.