Review: PDF OnlyCurrent and Potential Applications for Indocyanine Green in Liver TransplantationLau, Ngee-Soon MD1,2; Ly, Mark MBBS1,2; Liu, Ken MBBS1,2,3; Majumdar, Avik PhD1,2; McCaughan, Geoffrey PhD1,2,3; Crawford, Michael MD1; Pulitano, Carlo PhD1,2 Author Information 1Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital, Sydney, NSW, Australia. 2Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. 3Centenary Research Institute, Sydney, NSW, Australia. Received 20 August 2021. Revision received 15 October 2021. Accepted 10 November 2021. The authors declare no funding or conflicts of interest. N.-S.L. participated in research design, analyzed the literature, and wrote the article. M.L. and C.P. participated in research design, analyzed the literature, and reviewed the article. K.L., A.M., G.M., and M.C. participated in research design and reviewed the article. Correspondence: Carlo Pulitano, PhD, Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, Sydney, NSW 2050, Australia. ([email protected]). Transplantation: December 27, 2021 - Volume - Issue - doi: 10.1097/TP.0000000000004024 Buy PAP Metrics Abstract Indocyanine green (ICG) is a fluorescent dye taken up and almost exclusively cleared by the liver. Measurement of its clearance and visualization of its fluorescence make it suitable for a number of potential applications in liver transplantation including assessment of liver function and real-time assessment of arterial, venous, and biliary structures. ICG clearance can be used to assess donor graft quality before procurement and graft metabolic function before transplant using normothermic ex vivo machine perfusion. ICG clearance in the post–liver transplantation period is able to predict recipient outcomes with correlations to early allograft dysfunction and postoperative complications. After absorbing light in the near-infrared spectrum, ICG also emits fluorescence at 835 nm. This allows the assessment of vascular patency after reconstruction and patterns of liver perfusion in real time. ICG perfusion patterns after revascularization are also associated with posttransplant graft function and survival. ICG fluorescence cholangiography is routine in a number of centers and acts as an aid to identifying the optimal point of bile duct division during living donor liver transplantation to optimize safety for both donor and recipient. In summary, ICG is a versatile tool and has a number of useful applications in the liver transplantation journey including assessment of liver function, perfusion assessment, and cholangiography. Further research and clinical trials are required to validate and standardize its routine use in liver transplantation. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.