title: Compared efficacy of preservation solutions in liver transplantation: a long-term graft outcome study from the European Liver Transplant Registry.
abstract: Between 2003 and 2012, 42 869 first liver transplantations performed in Europe with the use of either University of Wisconsin solution (UW; N = 24 562), histidine-tryptophan-ketoglutarate(HTK; N = 8696), Celsior solution (CE; N = 7756) or Institute Georges Lopez preservation solution (IGL-1; N = 1855) preserved grafts. Alternative solutions to the UW were increasingly used during the last decade. Overall, 3-year graft survival was higher with UW, IGL-1 and CE (75%, 75% and 73%, respectively), compared to the HTK (69%) (p < 0.0001). The same trend was observed with a total ischemia time (TIT) >12 h or grafts used for patients with cancer (p < 0.0001). For partial grafts, 3-year graft survival was 89% for IGL-1, 67% for UW, 68% for CE and 64% for HTK (p = 0.009). Multivariate analysis identified HTK as an independent factor of graft loss, with recipient HIV (+), donor age ≥65 years, recipient HCV (+), main disease acute hepatic failure, use of a partial liver graft, recipient age ≥60 years, no identical ABO compatibility, recipient hepatitis B surface antigen (-), TIT ≥ 12 h, male recipient and main disease other than cirrhosis. HTK appears to be an independent risk factor of graft loss. Both UW and IGL-1, and CE to a lesser extent, provides similar results for full size grafts. For partial deceased donor liver grafts, IGL-1 tends to offer the best graft outcome.
authors.affiliation: Centre Hépatobiliaire, AP-HP Hôpital Paul Brousse, Inserm U 776, Univ Paris Sud, Villejuif, France.
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.forename: V
authors.initials: V
authors.lastname: Delvart
authors.forename: V
authors.initials: V
authors.lastname: Karam
authors.forename: C
authors.initials: C
authors.lastname: Ducerf
authors.forename: F
authors.initials: F
authors.lastname: Navarro
authors.forename: C
authors.initials: C
authors.lastname: Letoublon
authors.forename: J
authors.initials: J
authors.lastname: Belghiti
authors.forename: D
authors.initials: D
authors.lastname: Pezet
authors.forename: D
authors.initials: D
authors.lastname: Castaing
authors.forename: Y P
authors.initials: YP
authors.lastname: Le Treut
authors.forename: J
authors.initials: J
authors.lastname: Gugenheim
authors.forename: P
authors.initials: P
authors.lastname: Bachellier
authors.forename: J
authors.initials: J
authors.lastname: Pirenne
authors.forename: P
authors.initials: P
authors.lastname: Muiesan
mesh_terms: D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D004187:Disaccharides; D004573:Electrolytes; D005060:Europe; D005260:Female; D005947:Glucose; D005971:Glutamates; D005978:Glutathione; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival / Q000502:physiology*; D006639:Histidine; D006801:Humans; D015994:Incidence; D007328:Insulin; D008099:Liver / Q000502:physiology*; D016031:Liver Transplantation / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D015999:Multivariate Analysis; D019188:Organ Preservation Solutions; D011189:Potassium Chloride; D011343:Procaine; D011887:Raffinose; D012042:Registries; D012189:Retrospective Studies
chemical_list: C039984:Bretschneider cardioplegic solution; C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; C504757:IGL-1 solution; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D006639:Histidine; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose