A multicenter pilot prospective study comparing Celsior and University of Wisconsin preserving solutions for use in liver transplantation.
Primary dysfunction (PDF) still occurs after orthotopic liver transplantation (OLT). Celsior solution (CS) might offer some advantages over the conventional University of Wisconsin (UW) solution for organ preservation, but to date, this has not been prospectively evaluated in the context of OLT. In this prospective, randomized, multicenter, pilot study, 215 potential liver donors were enrolled and randomized. In 42 cases, the livers were unsuitable for transplantation; therefore, 173 randomized livers ultimately were implanted after perfusion and cold preservation with CS (n = 83) or UW solution (n = 90). In accord with the indications of the CS manufacturing company, total CS infusion volume was 90 mL/kg, greater than that of UW solution (60 mL/kg). The main aim of the study is to compare the prevalence of PDF between the two groups. Donor and recipient variables were similar in the two groups. Episodes of PDF were numerically lower in the CS (2.4%) than UW group (7.8%), but the difference was not statistically significant. There was a trend toward a lesser need for early re-OLT (<30 days) in the CS group (P =.0507), but again, no statistically significant difference emerged. Overall and time-differentiated postoperative deaths also were similar. One-year actuarial patient (UW, 89% v CS, 87%) and graft (UW, 83% v CS, 85%) survival rates were similar. In conclusion, CS was similar to UW solution as a preservation solution in the clinical setting of OLT at the infusion volumes described, although some theoretical advantages of CS composition suggest that CS might prove a valid alternative to UW preservation solution in multiorgan harvesting, including the liver. A study on a larger patient basis is needed.
Cavallari
Antonino
A
Dipartimento di Discipline Chirurgiche, Rianimatorie e dei Trapianti Policlinico S Orsola, University of Bologna, Italy.
Cillo
Umberto
U
Nardo
Bruno
B
Filipponi
Franco
F
Gringeri
Enrico
E
Montalti
Roberto
R
Vistoli
Fabio
F
D'amico
Francesco
F
Faenza
Antonio
A
Mosca
Franco
F
Vitale
Alessandro
A
D'amico
Davide
D
D000241:Adenosine / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D004187:Disaccharides / Q000627:therapeutic use*; D004573:Electrolytes / Q000627:therapeutic use*; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D005978:Glutathione / Q000627:therapeutic use*; D006639:Histidine / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008099:Liver; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008353:Mannitol / Q000627:therapeutic use*; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000627:therapeutic use*; D011446:Prospective Studies; D011887:Raffinose / Q000627:therapeutic use*
C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D006639:Histidine; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose