A comparison of UW with Eurocollins preservation solution in liver transplantation.
Fifty consecutive liver transplants were performed using livers perfused with and stored in University of Wisconsin preservation solution. These grafts were compared with the preceding 55 consecutive transplants performed using livers perfused and preserved with Eurocollins solution. The purpose of the study was to determine if organs preserved with UW solution functioned better after transplantation than organs preserved with Eurocollins. Extensive retrospective analysis of prospectively accumulated data included enzyme levels through 30 days, cost and length of hospital stay, blood product usage, and ischemia time. Average age of patients in the UW group was 47.1 years compared with 39.6 years in the EC group (P less than 0.05); cold ischemia time was 7.21 hr in the UW group compared with 5.21 in EC (P = 0.0001). Total bilirubin values were significantly lower on days 0-6 and day 14, but not day 30, in the UW group. Aspartate aminotransferase was significantly lower in the UW group on days 0-1, 3-6, and 14, but not on day 3 or day 30. Prothrombin times were significantly lower in the UW group across all times (days 0-6, 14, and 30). Intraoperative and postoperative use of packed red blood cells and fresh frozen plasma was lower in the UW group (P less than or equal to .05). Also, total hospital days, intensive care unit days, and hospital cost to the patient were lower in the UW group (P less than or equal to .05). A second analysis was done comparing only nonemergent transplants from both groups. These results confirmed the initial analysis of a longer cold ischemia time in the UW group (P less than 0.001), and improved enzyme values in the TBR, AST, and PT in the UW group (P less than 0.05). Also, hospital cost in the UW group was again lower (P less than 0.05). In this nonrandomized study, the cold ischemia time was increased but kept close to that of the control group. We conclude that UW solution is an improved donor liver preservation solution on the basis of improved enzyme values, decreased blood usage, shorter hospital stay, and lower hospital charges.
Cofer
J B
JB
Transplantation Services, Baylor University Medical Center, Dallas, Texas 75246.
Klintmalm
G B
GB
Howard
T K
TK
Morris
C V
CV
Husberg
B S
BS
Goldstein
R M
RM
Gonwa
T A
TA
D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D003365:Costs and Cost Analysis; D005260:Female; D005978:Glutathione; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D006982:Hypertonic Solutions / Q000494:pharmacology*; D007328:Insulin; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011887:Raffinose; D012189:Retrospective Studies; D012996:Solutions / Q000494:pharmacology*; D014021:Tissue Preservation / Q000379:methods*
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose