2026-04-19T19:20:54Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/135312025-10-24T10:36:11Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Huerta García, Martín author Fernandes Montes, Nair Sonia author Dalmau, Mar author DOPAZO, CRISTINA author Caralt, Mireia author Vidal Fornells, Laura author Charco, Ramon author Bilbao, Itxarone author Gómez Gavara, Concepción author 2025-08-12T11:54:40Z 2025-08-12T11:54:40Z 2025-06-09 Health Technology; Technology Tecnologia de la salut; Tecnologia Tecnología de la salud; Tecnología Objectives Evaluate the effectiveness of indocyanine green (ICG) fluorescence in enhancing the safety and precision of biliary anastomosis during liver transplantation (LT). The primary research question was whether ICG could provide real-time, objective assessment of bile duct vascularization to reduce postoperative biliary complications. Design Prospective, observational case series. IDEAL Stage 1 study. Setting Tertiary care academic medical center in Barcelona, Spain. Participants 10 adult patients who underwent LT between January 2023 and July 2024. Patients were selected based on the indication for LT with varying etiologies of liver failure. Donors included those with brain death and circulatory death (DCD). Interventions ICG was administered intravenously as a 3 mg bolus dose to evaluate the vascularization of the bile duct stumps. Fluorescence was visualized using a high-definition camera system during surgery, and adjustments to the anastomosis site were made based on the fluorescence patterns observed. Main outcome measures The primary outcome was the identification of non-vascularized (non-fluorescent) bile duct tissue and subsequent adjustments to the anastomosis site. Secondary outcomes included the incidence of biliary complications and patient survival during the follow-up period. Results ICG fluorescence successfully identified non-fluorescent areas in the bile duct stumps, leading to surgical adjustments in five cases (50%), particularly in DCD grafts. The procedure was well-tolerated with no adverse events related to ICG administration. The use of ICG fluorescence added an average of 3–5 min to the operative time. No biliary complications were reported during follow-up, and patient survival was 100%. Conclusions ICG fluorescence provides a valuable, objective tool for assessing bile duct vascularization during LT, potentially reducing biliary complications. This technique’s integration into clinical practice could enhance surgical precision and improve patient outcomes. Further research is needed to confirm these findings in larger, more diverse populations. http://hdl.handle.net/11351/13531 Fetge - Trasplantació Fluorescència Tracte biliar - Cirurgia Avaluació de resultats (Assistència sanitària) ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Cell- and Tissue-Based Therapy::Tissue Transplantation::Liver Transplantation CHEMICALS AND DRUGS::Heterocyclic Compounds::Heterocyclic Compounds, Fused-Ring::Heterocyclic Compounds, 2-Ring::Indoles::Indocyanine Green PHENOMENA AND PROCESSES::Physical Phenomena::Magnetic Phenomena::Electromagnetic Phenomena::Electromagnetic Radiation::Light::Luminescence::Fluorescence ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Anastomosis, Surgical ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::tratamientos basados en células y tejidos::trasplante de tejidos::trasplante de hígado COMPUESTOS QUÍMICOS Y DROGAS::compuestos heterocíclicos::compuestos heterocíclicos con anillos de fusión::compuestos heterocíclicos de 2 anillos::indoles::verde indocianina FENÓMENOS Y PROCESOS::fenómenos físicos::fenómenos magnéticos::fenómenos electromagnéticos::radiación electromagnética::luz::luminiscencia::fluorescencia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::anastomosis quirúrgica TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Brightening the path to safe liver transplants: the role of ICG fluorescence in biliary anastomosis