Celsior versus Wisconsin solution in pancreas transplantation.
Celsior solution (CS), which has recently become available, that might theoretically offer a new means for improving graft preservation quality. The present prospective, randomized study was designed to evaluate the efficacy of CS compared with University of Wisconsin (UW) for pancreas allografts. Between January 2001 and January 2007, 88 patients underwent pancreatic transplantation, including the last 30 consecutive simultaneous pancreas kidney patients who were randomly assigned to either CS or UW. There was no case of graft thrombosis in either group. There were 2 cases of pancreatitis in the UW group compared with 1 in the CS group. No case of primary nonfunction occurred in either group. There were 2 cases of early duodenal stump fistulae in the CS group that required transplantectomy, whereas this complication was not observed in the UW group. Relaparotomy in the UW group was required in 3 cases due to infection and treated by close drainage that which, progressed to fatal sepsis in 1 patient. In the UW group with 6 months of follow-up, there were 12 patients insulin free. In the CS group, 6 patients underwent relaparotomy, 3 for transplantectomy and the others for intra-abdominal infection, which was fatal in 2 cases. In the CS group with 6 months of follow-up, there were 10 patients insulin free. Two patients died with functioning grafts. These results provided indirect evidence that CS solution is at least as safe as UW to mitigate postreperfusion graft edema and pancreatitis, as well as graft thrombosis.
Nicoluzzi
J
J
Department of Surgery, Faculty of Medicine, PUC-PR Brazil, Parana, Brazil.
Macri
M
M
Fukushima
J
J
Pereira
A
A
D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D004187:Disaccharides; D004573:Electrolytes; D005260:Female; D005971:Glutamates; D005978:Glutathione; D006639:Histidine; D006801:Humans; D007328:Insulin; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods / Q000502:physiology*; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D019188:Organ Preservation Solutions; D010179:Pancreas / Q000187:drug effects; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods / Q000502:physiology*; D011887:Raffinose; D015427:Reperfusion Injury / Q000453:epidemiology* / Q000517:prevention & control; D012449:Safety; D055815:Young Adult
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