A prospective randomized clinical trial of liver preservation using high-sodium versus high-potassium lactobionate/raffinose solution.
High-sodium as opposed to high-potassium lactobionate/raffinose preservation solution offers potential advantages in improving the quality of liver storage by reducing potassium-induced vasoconstriction and preventing hyperkalaemia on reperfusion. In our study we evaluated in a prospective trial (encompassing 40 consecutive cadaver donor hepatic retrievals and subsequent transplants) the efficacy of a high-sodium formulation versus the standard high-potassium solution. Quality of preservation was assessed by clinical indices of liver function in the intraoperative and early postoperative phases, including measurements of requirements for blood and blood products and potassium, circulating liver enzymes and bilirubin. Frequencies of acute rejection episodes and primary non-function were also recorded. No significant differences were evident in any of the measured parameters. Thus a sodium-based solution can be used for hepatic preservation, advancing the possibility that it may be possible to develop a single storage solution for clinical multi-organ donor operations.
University Department of Surgery, Royal Free Hospital & School of Medicine, London, UK.
T R
TR
Kurzawinski
J A
JA
Appleby
S C
SC
Hardy
B
B
Fuller
K
K
Cheetham
D
D
Haswell
B
B
Davidson
K
K
Rolles
D000328:Adult; D002102:Cadaver; D004187:Disaccharides; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007432:Intraoperative Period; D008099:Liver; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods / Q000473:pathology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011183:Postoperative Complications; D011184:Postoperative Period; D011188:Potassium; D011446:Prospective Studies; D011887:Raffinose; D015427:Reperfusion Injury / Q000517:prevention & control; D014019:Tissue Donors
D004187:Disaccharides; D019188:Organ Preservation Solutions; C005608:lactobionic acid; D011887:Raffinose; D011188:Potassium