Comparative prospective study of two liver graft preservation solutions: University of Wisconsin and Celsior.
University of Wisconsin solution (UWS) is the gold standard for graft preservation. Celsior solution (CS) is a new solution not as yet widely used in liver grafts. The aim of this study was to compare the liver function of transplanted grafts stored in these 2 preservation solutions. The primary endpoints were the rates of primary nonfunction (PNF) and primary dysfunction (PDF). We performed a prospective and pseudorandomized study that included 196 patients (representing 104 and 92 livers preserved in UWS and CS, respectively) at La Fe University Hospital (Valencia, Spain) between March 2003 and May 2005. PNF and PDF rates, liver function laboratory parameters, postoperative bleeding, vascular and biliary complications, and patient and graft survival at 3 years were compared for the 2 groups. The 2 groups were similar in terms of donor variables, recipient variables, and surgical techniques. The PNF rates were 2.2% and 1.9% in the CS and UWS groups, respectively (P = not significant), and the PDF rates were 15.2% and 15.5% in the CS and UWS groups, respectively (P = not significant). There were no significant differences in the laboratory parameters for the 2 groups, except for alanine aminotransferase levels in month 3, which were lower in the CS group (P = 0.01). No significant differences were observed in terms of complications. Three-year patient and graft survival rates were as follows for years 1, 2, and 3: 83%, 80%, and 76% (patient) and 80%, 77%, and 73% (graft) for the UWS group and 83%, 77%, and 70% (patient) and 81%, 73%, and 67% (graft) for the CS group (P = not significant). In conclusion, this study shows that CS is as effective as UWS in liver preservation.
Lopez-Andujar
Rafael
R
Hepatic Surgery and Liver Transplant Unit, La Fe University Hospital, Valencia, Spain. rlopezandujar@telefonica.net
Deusa
Saulo
S
Montalvá
Eva
E
San Juan
Fernando
F
Moya
Angel
A
Pareja
Eugenia
E
DeJuan
Manuel
M
Berenguer
Marina
M
Prieto
Martín
M
Mir
Jose
J
D000241:Adenosine / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D001660:Biliary Tract Diseases / Q000209:etiology; D004187:Disaccharides / Q000009:adverse effects / Q000627:therapeutic use; D004573:Electrolytes / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005971:Glutamates / Q000009:adverse effects / Q000627:therapeutic use; D005978:Glutathione / Q000009:adverse effects / Q000627:therapeutic use; D006085:Graft Survival / Q000187:drug effects; D006639:Histidine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects* / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008353:Mannitol / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000627:therapeutic use*; D010865:Pilot Projects; D019106:Postoperative Hemorrhage / Q000209:etiology; D055031:Primary Graft Dysfunction / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011887:Raffinose / Q000627:therapeutic use; D013997:Time Factors; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000209:etiology; 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