Comparison of Celsior and University of Wisconsin solutions in cold preservation of liver from octogenarian donors.
BACKGROUND
Celsior (CS) has recently been proposed as a cold storage solution for thoracic and abdominal organs. We compared University of Wisconsin (UW) and CS solutions for the preservation of livers from old donors, with regard to initial function as well as short- and long-term graft and patient survival.


METHODS
A multicenter retrospective study from 1998 to 2002 includes 30 livers from octogenarian donors preserved in CS (n = 15) or UW (n = 15) solution prior to transplantation. Donor and recipient clinical and laboratory parameters as well as liver biopsy results were evaluated in all cases.


RESULTS
The distribution of the main donor variables as well as recipient characteristics were comparable between groups. Mean cold ischemia time was 421 minutes in the CS group and 474 minutes in the UW group. Mild steatosis was present in 8 cases in the CS group and 7 cases in the UW group. No primary graft dysfunction or arterial or biliary complications were noted. There was 1 acute rejection episode in the CS group and 4 in the UW group. Late postoperative deaths were observed only in the UW group (ie, 7 of 15). Actuarial graft survival was 100% in the CS group vs 86.7% in the UW group (P = NS) at 3 months, and 100% in the CS group vs 52.5% in the UW group (P =.007) at 12 months. Patient survival was 100% in the CS group vs 93.3% in the UW group (P = NS) at 3 months, and 100% in the CS group vs 59.3% in the UW group (P =.01) at 12 months.


CONCLUSIONS
Both CS and UW solutions effectively protect livers obtained from donors >80 years of age during the early postoperative course but the CS group had better long-term results.
Nardo
B
B
Department of Surgery and Transplantation, University of Bologna, Bologna, Italy. nardo@orsola-malpighi.med.unibo.it
Beltempo
P
P
Bertelli
R
R
Montalti
R
R
Vivarelli
M
M
Urbani
L
L
Masetti
M
M
Di Naro
A
A
Filipponi
F
F
Mosca
F
F
Pinna
A
A
Cavallari
A
A
D000241:Adenosine; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D005978:Glutathione; D006085:Graft Survival / Q000502:physiology*; D006639:Histidine; D006801:Humans; D007328:Insulin; D008099:Liver; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008353:Mannitol; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011887:Raffinose; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data*
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