title: Efficacy and safety of Celsior preservation fluid in liver transplantation: one-year follow up of a prospective, multicenter, non-randomized study.
abstract: The purpose of this prospective, nine-center, non-randomized study was to assess the efficacy and safety of Celsior preservation fluid in liver transplantation using unselected donors. As data comparing allograft outcomes following liver transplantation using Celsior and University of Wisconsin (UW) preservation fluids are limited, we also compared our cohort with matched controls selected from the European Liver Transplant Registry (ELTR) who received total liver grafts preserved with UW solution during the same period. One hundred and forty patients who received livers preserved with Celsior were included. The primary endpoint, graft loss at one-yr post-transplantation, was observed in 24 patients (17.1%) which was not significantly different from the 20.0% pre-defined threshold rate (95% confidence interval [CI] 10.9, 23.4; p=0.398). Predictive factors for graft loss on univariate analysis were moderate-to-severe steatosis on the donor graft (5/22 patients with graft loss vs. 8/107 patients without, p=0.046) and duration of warm ischemia (1.4±1.1 h in patients with graft loss vs. 0.9±0.5 h in patients without, p=0.034). Hepatic artery thrombosis and stenosis occurred in seven (5.0%) and six (4.3%) patients, respectively. The comparison of our patients to 420 ELTR controls showed that one-yr graft survival rates (Celsior: 82.9%, 95% CI 75.8, 88.2; UW: 78.6%, 95% CI 74.4, 82.2) and Kaplan-Meier one-yr graft survival distributions (p=0.285) were similar. Within the cold ischemia time achieved in our study, liver preservation with Celsior appeared efficient and safe. Comparison with ELTR patients suggested that liver allograft survival was similar using Celsior or UW solution for preservation of unselected donor grafts.
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes, France. karim.boudjema@chu-rennes.fr
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
authors.forename: Stéphane
authors.initials: S
authors.lastname: Grandadam
authors.forename: Philippe
authors.initials: P
authors.lastname: Compagnon
authors.forename: Ephrem
authors.initials: E
authors.lastname: Salamé
authors.forename: Philippe
authors.initials: P
authors.lastname: Wolf
authors.forename: Christian
authors.initials: C
authors.lastname: Ducerf
authors.forename: Patrice
authors.initials: P
authors.lastname: Le Treut
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
authors.forename: Catherine
authors.initials: C
authors.lastname: Mouchel
authors.forename: Alain
authors.initials: A
authors.lastname: Renault
authors.forename: Eric
authors.initials: E
authors.lastname: Bellissant
mesh_terms: D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D004187:Disaccharides; D004573:Electrolytes; D005260:Female; D005971:Glutamates; D005978:Glutathione; D006085:Graft Survival; D006639:Histidine; D006801:Humans; D007328:Insulin; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D019188:Organ Preservation Solutions; D055031:Primary Graft Dysfunction / Q000175:diagnosis; D011887:Raffinose
chemical_list: 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