title: The effect of preservation solutions for storage of liver allografts on transplant outcomes: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The objective of this review was to systematically evaluate the evidence comparing preservation fluids for liver allografts on transplant outcomes.
  
  
  BACKGROUND
  Adequate preservation of liver allografts for transplantation is essential for successful transplant outcomes. There are several preservation fluids available that have been specifically designed for the static cold storage of livers. These fluids differ in composition and cost.
  
  
  METHODS
  literature search was performed using MEDLINE, EMBASE, Cochrane Library, Transplant Library, and the International Clinical Trials Registry Platform. Only randomized controlled trials were included. Studies were assessed for methodological quality. Primary outcomes were the risk of early dysfunction, primary nonfunction, retransplantation, patient survival, and graft survival. Secondary outcomes were serum biochemical parameters in the first week and biliary complications. Summary effects were calculated as relative risk and relative log survival with 95% confidence intervals (95% CIs).
  
  
  RESULTS
  Sixteen randomized controlled trials met the full inclusion criteria (1619 livers). There is good evidence that the University of Wisconsin and Celsior solutions are associated with the same rates of early dysfunction (relative risk = 1.08, 95% CI = 0.63-1.86, P = 0.77), primary nonfunction (relative risk = 0.73, 95% CI = 0.22-2.40, P = 0.60), patient survival (relative log survival = 0.86, 95% CI = 0.58-1.28, P = 0.46), and graft survival (relative log survival = 0.85, 95% CI = 0.59-1.23, P = 0.39). There was no good evidence of any difference in outcomes when comparing histidine-tryptophan-ketoglutarate with either of the University of Wisconsin or Celsior solution, although data were limited.
  
  
  CONCLUSIONS
  Data from included studies suggest that preservation of deceased donor livers with the University of Wisconsin or Celsior solution results in equivalent outcomes.
authors.affiliation: *Centre for Evidence in Transplantation, Royal College of Surgeons of England and London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom; and †Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: John M
authors.initials: JM
authors.lastname: OʼCallaghan
authors.forename: Robert D
authors.initials: RD
authors.lastname: Morgan
authors.forename: Simon R
authors.initials: SR
authors.lastname: Knight
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Morris
mesh_terms: D064591:Allografts; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology*
chemical_list: D019188:Organ Preservation Solutions