To explore the clinical value of indocyanine green (ICG) test combined with two-dimensional shear wave elastography (2D SWE) in evaluating the quality of donor liver.

A retrospective analysis of 21 brain-dead donors from the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from May 2018 to November 2018 was conducted. All the donor livers were evaluated by ICG and 2D SWE test in ICU before donor liver acquisition. According to the early recovery of liver function, 21 recipients were divided into observation group (6 cases, recipients with early graft dysfunction after transplantation) and control group (15 cases). The age and modle for end-stage liver disease scores (last time before transplantation) of the recipients, and the cold ischemia time, ICG-R15, ICG-PDR and Young′s modulus of the donor liver between the 2 groups were compared by two independent samples t test. The Child-Pugh scores (last time before transplantation) and anhepatic stage between the 2 groups were compared by Wilcoxon signed-rank test. Receiver operator characteristic (ROC) was used to compare the predictive effect of different parameters on early allograft dysfunction after liver transplantation. P<0.05 was considered statistically significant.

The age of recipients of observation group and control group were (38±13) years and (54±6) years, respectively, the difference was statistically significant (t=2.840, P<0.05). The ICG-R15 of donor liver of observation group and control group were (5.5±3.0)% and (3.2±1.4)%, respectively, the difference was statistically significant (t=-2.386, P<0.05); the ICG-PDR of donor liver of observation group and control group were (21±5) %/min and (24±4) %/min, respectively, Young′s modulus of donor liver of observation group and control group were (5.0±1.3) kPa and (3.9±2.6) kPa, respectively, and there was no significant difference (t=1.655 and -0.930, P all>0.05). The area under ROC of ICG-R15 on predication of early graft dysfunction after liver transplantation was 0.767 (95%CI: 0.490-1.000, P>0.05), the area under ROC of ICG-PDR was 0.789 (95%CI: 0.513-1.000, P<0.05), the area under ROC of 2D SWE was 0.756 (95%CI: 0.5392-0.9719, P>0.05), the area under ROC of ICG-R15 and ICG-PDR was 0.767 (95%CI: 0.490-1.000, P>0.05). The area under ROC of ICG-R15, ICG-PDR and 2D SWE was 0.822 (95%CI: 0.608-1.000, P<0.05), the best cut-off for the prediction of early graft dysfunction were ICG-R15=4.15%, ICG-PDR=21.7 %/min, Young′s modulus=3.00 kPa, with a sensitivity of 83.3% and a specificity of 86.7%.

The prediction on early graft dysfunction after liver transplantation by ICG test combined with 2D SWE test was better than that by 2D SWE or ICG, with the advantage of non-invasive, simple and quantitative evaluation.