Randomized clinical assay for hepatic grafts preservation with University of Wisconsin or histidine-tryptophan-ketoglutarate solutions in liver transplantation.
University of Wisconsin (UW) solution has been the standard for preservation of liver transplantation grafts since 1989. However, some studies demonstrated that histidine-tryptophan-ketoglutarate (HTK) solution is also effective. The purpose of this study was to compare the efficacy of both solutions in liver transplantation. From January 2003 to August 2004 the livers of deceased donors were randomized into HTK and UW groups. The 102 studied patients included 65 (63.7%) in the UW group and 37 (36.3%) in the HTK group. Sex, race, hemodynamic state, use of adrenergic drugs, and presence of steatosis in the donor were similarly distributed in the two groups (P > .05). The mean age of the donors was 38.1 years (SD +/-14.4) in the UW group and 44.6 years (SD +/-14.2) in the HTK cohort (P = .036). Sex, race, age, etiology of the cirrhosis, retransplant, acute liver failure, portal thrombosis, and Child-Pugh and MELD scores in the recipients were similarly distributed in the two recipient samples (P > .05). Among 89 patients who completed 4 months of follow-up, the HTK group included eight cases (25.8%) of biliary complications versus five cases (8.6%) in the UW group (P = .033; OR = 2.0 95% CI = 1.2-3.5). The incidence of graft dysfunction was 2.8% in the HTK group and 9.4% in the UW group (P = .15). In conclusion, UW and HTK solutions were equally effective for the preservation of the hepatic graft. The routine use of HTK solution can reduce the costs of liver transplantation.
Meine
M H
MH
Liver Transplantation Group, Santa Casa de Porto Alegre, Rua Professor Annes Dias 288, Porto Alegre, RS, CEP 90-020-020 Brazil. txhepatico@santacasa.tche.br
Zanotelli
M L
ML
Neumann
J
J
Kiss
G
G
de Jesus Grezzana
T
T
Leipnitz
I
I
Schlindwein
E S
ES
Fleck
A
A
Gleisner
A L
AL
de Mello Brandão
A
A
Marroni
C A
CA
Cantisani
G P C
GP
D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D005260:Female; D005978:Glutathione; D006085:Graft Survival; D006639:Histidine; D006801:Humans; D007328:Insulin; D008099:Liver; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011887:Raffinose; D015996:Survival Rate; D016896:Treatment Outcome; D014364:Tryptophan
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D006639:Histidine; D000493:Allopurinol; D014364:Tryptophan; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose