Beneficial effects of Eurocollins as aortic flush for the procurement of human livers.
A review of 550 consecutively transplanted liver grafts stored in University of Wisconsin solution (UW) was performed during a 4-year period to ascertain whether graft function was impaired by flushing the aorta with Eurocollins (EC) rather than UW during the harvesting. The outcome of 255 liver grafts flushed with UW in both the aorta and portal vein (group UW/UW) was compared with 295 liver grafts flushed with EC through the aorta and UW through the portal vein (group ECUW). Liver grafts in both groups were flushed with 1 L of UW during the back table procedure and subsequently stored in UW at 4 degrees C before transport. Donor and recipient characteristics, cold and warm ischemia times, and methods of transplantation were similar in both groups, except that the recipient prothrombin time (PT) before liver transplantation (LT) was lower in the UW/UW group. There was no significant difference between the groups with peak transaminases aspartate aminotransferase (AST) and alanine aminotransferase, maximum value of serum bilirubin within 10 days following LT, incidence of primary nonfunction, need for retransplantation, and patient and graft survival at 1 month. Results were improved, however, in the EC/UW group in regard to PT after LT, operative bleeding and proportion of grafts with histologic lesions at the reperfusion biopsy (P<0.001). These better results in the EC/UW group were confirmed when grafts transplanted in urgent situations were excluded from analysis and by multivariate analysis assessing the effects of pretransplant PT and AST values of the recipients combined with the method of liver cooling with each of the aforementioned criteria. In conclusion, the method of using EC for the aortic flush during liver procurement reduces the amount of UW solution by 50% with improved graft function. This method seems justified in that it is less expensive while affording improved graft function.
Adam
R
R
Hepato-Biliary Surgery and Liver Transplant Unit and Service d'Anatomie Patholique, Paul Brousse Hospital, Villejuif, France.
Astarcioglu
I
I
Raccuia
J S
JS
Ducot
B
B
Reynes
M
M
Bismuth
H
H
D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000493:Allopurinol / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006801:Humans; D006982:Hypertonic Solutions / Q000494:pharmacology*; D007328:Insulin / Q000494:pharmacology; D016031:Liver Transplantation; D008875:Middle Aged; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011887:Raffinose / Q000494:pharmacology; D009927:Tissue and Organ Procurement
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose