Effect of cold ischemia time on the early outcome of human hepatic allografts preserved with UW solution.
Five hundred ninety-three cadaveric livers were used for primary liver transplantation between October 24, 1987, and May 19, 1989. The grafts were procured with a combined method, using in situ cooling with cold electrolyte solution and backtable flushing with UW solution. The mean cold-ischemia time was 12.8 (range 2.4-34.7) hr. The cases were divided into 5 groups according to the cold-ischemia time: group 1: less than 10 hr (n = 223); group 2: 10-14 hr (n = 188); group 3: 15-19 hr (n = 101); group 4: 20-24 hr (n = 52); and group 5: greater than or equal to 25 hr (n = 29). There was no difference between the 5 groups in 1-year patient survival, highest SGOT in first week after operation, and SGOT and total bilirubin during the first month after operation. However, with a logistic regression model, the retransplantation rate (P = 0.001) and primary nonfunction rate (P = 0.006) significantly rose as cold-ischemia time increased, meaning that the equivalency of patient survival was increasingly dependent on aggressive retransplantation.
Furukawa
H
H
Department of Surgery, University of Pittsburgh, Pennsylvania.
Todo
S
S
Imventarza
O
O
Casavilla
A
A
Wu
Y M
YM
Scotti-Foglieni
C
C
Broznick
B
B
Bryant
J
J
Day
R
R
Starzl
T E
TE
D000241:Adenosine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature; D005978:Glutathione; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin; D007511:Ischemia / Q000503:physiopathology*; D008099:Liver / Q000098:blood supply / Q000503:physiopathology; D016031:Liver Transplantation; D008875:Middle Aged; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011887:Raffinose; D012086:Reoperation; D012996:Solutions; D013997:Time Factors; D014184:Transplantation, Homologous
D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose