Developmet of Clye cleavano with near-infrared tissue spectroscopy

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Indocyanine green has a specific absorbance at 805nm in the near-infrared light region. Therefore, we have evaluated absorbance of indocyanine green after excluding oxy-hemoglobin and deoxyhemoglobin, oxidized and reduced cytochrome c oxidase and washed out liver components by multiple curve fitting analysis with tissue near-infrared spectroscopy. With this novel method, we have evaluated tissue oxygenation at the sinusoid level by oxygen saturation of hemoglobin of the red cells, transmembrane transport of indocyanine green by a rate constant of increase phase after indocyanine green administration, and intracellular transport and excretion through bile canaliculi by a rate constant of the decrease phase, respectively. Increase phase after administration was inhibited by bilirubin as a competitive inhibitor of transmembrane uptake of indocyanine green. Decrease phase was inhibited both by colchicine and ouabain via destruction of microtubules in the hepatocyte and suppression of Na-K … More ATPase at bile canaliculi membrane, respectively. Therefore, these two rate constants were certified to be an indicator of transmembrane uptake and intracellular transport and excretion through bile canaliculi of indocyauine green. We applied this method to ischemia reperfusion injury in the liver and showed that transmembrane uptake was injured by ischemia reperfusion injury but recovered rapidly, while deterioration of intracellular transport and excretion through bile canaliculi continued much longer. Since these injuries were related to intracellular decrease of ATP,these injuries were suspected to be caused by deterioration of intracellular Ca metabolism. Furthermore, we used this method for divided liver function tests. We have measured indocyanine green uptake and excretion in the ischemic lobe and control lobe simultaneously. This study showed that non-ischemic lobe was affected by the contralateral ischemic lobe in terms of dye excretion, indicating that ischemic insult should be avoided as less as possible in liver resection. Less