Prediction of Survival After Partial Hepatectomy Using a Physiologically Based Pharmacokinetic Model of Indocyanine Green Liver Function Tests
Autor: | Matthias König, Michael Tautenhahn, Adrian Köller, Jan Grzegorzewski |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Physiologically based pharmacokinetic modelling Cirrhosis indocyanine green genetic structures Physiology medicine.medical_treatment liver cirrhosis Urology Context (language use) chemistry.chemical_compound Liver disease hepatectomy Internal medicine Medicine QP1-981 ddc:610 Original Research medicine.diagnostic_test business.industry Hepatology medicine.disease eye diseases body regions computational model chemistry liver function liver resection Hepatectomy business Liver function tests 610 Medizin und Gesundheit Indocyanine green pharmacokinetics mathematical model |
Zdroj: | Frontiers in Physiology, Vol 12 (2021) Frontiers in Physiology |
Popis: | This article was supported by the German Research Foundation (DFG) and the Open Access Publication Fund of Humboldt-Universität zu Berlin. The evaluation of hepatic function and functional capacity of the liver are essential tasks in hepatology as well as in hepatobiliary surgery. Indocyanine green (ICG) is a widely applied test compound that is used in clinical routine to evaluate hepatic function. Important questions for the functional evaluation with ICG in the context of hepatectomy are how liver disease such as cirrhosis alters ICG elimination, and if postoperative survival can be predicted from preoperative ICG measurements. Within this work a physiologically based pharmacokinetic (PBPK) model of ICG was developed and applied to the prediction of the effects of a liver resection under various degrees of cirrhosis. For the parametrization of the computational model and validation of model predictions a database of ICG pharmacokinetic data was established. The model was applied (i) to study the effect of liver cirrhosis and liver resection on ICG pharmacokinetics; and (ii) to evaluate the model-based prediction of postoperative ICG-R15 (retention ratio 15 min after administration) as a measure for postoperative outcome. Key results are the accurate prediction of changes in ICG pharmacokinetics caused by liver cirrhosis and postoperative changes of ICG-elimination after liver resection, as validated with a wide range of data sets. Based on the PBPK model, individual survival after liver resection could be classified, demonstrating its potential value as a clinical tool. |
Databáze: | OpenAIRE |
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