[Outcomes using two preservation solutions (UW/HTK) in liver transplantation from brain death donors].

Abstract

BACKGROUND:

Preservation solutions are critical for organ transplantation. In liver transplant (LT), the solution developed by the University Of Wisconsin (UW) is the gold-standard to perfuse deceased brain death donor (DBD) grafts. Histidine-Tryptophan-Ketoglutarate (HTK), formerly a cardioplegic infusion, has been also used in solid organ transplantation.

AIM:

To compare the outcomes of LT in our center using either HTK or UW solution.

PATIENTS AND METHODS:

Retrospective study including 93 LT DBD liver grafts in 89 patients transplanted between March 1994 and July 2010. Forty-eight grafts were preserved with UW and 45 with HTK. Donor and recipient demographics, total infused volume, cold ischemia time, post-reperfusion biopsy, liver function tests, incidence of biliary complications, acute rejection and 12-month graft and patient survival were assessed. Preservation solution costs per liver graft were also recorded.

RESULTS:

Donor and recipient demographics were similar. When comparing UW and HTK, no differences were observed in cold ischemia time (9.6 ± 3 and 8.7 ± 2 h respectively, p = 0.23), biliary complications, the incidence of acute rejection, primary or delayed graft dysfunction. Histology on post-reperfusion biopsies revealed no differences between groups. The infused volume was significantly higher with HTK than with UW (9 (5-16) and 6 (3-11) l, p < 0.001). The cost per procurement was remarkably lower using HTK.

CONCLUSIONS:

Perfusion of DBD liver grafts with HTK is clinically equivalent to UW, with a significant cost reduction.

• Authors: Jorge Martínez, Jean P Bächler, Fabrizio Moisan, Javiera Torres, Ignacio Duarte, Rosa María Pérez, Carlos Benítez, Marco Arrese, Pilar Domínguez, Juan F Guerra, Nicolás Jarufe
• Journal: Revista medica de Chile (Rev Med Chil) Vol. 142 Issue 10 Pg. 1229-37 (Oct 2014) ISSN: 0717-6163 [Electronic] Chile
• Vernacular Title: ¿Influye el medio de preservación del injerto en los resultados y costos del trasplante hepático de donante fallecido?: Comparación de dos soluciones de preservación.
• PMID: 25601106 (Publication Type: Comparative Study, English Abstract, Journal Article)

Chemical References

• Bretschneider cardioplegic solution
• Insulin
• Organ Preservation Solutions
• University of Wisconsin-lactobionate solution
• Mannitol
• Procaine
• Allopurinol
• Potassium Chloride
• Glutathione
• Glucose
• Adenosine
• Raffinose

Topics

• Adenosine
• Adult
• Allopurinol
• Brain Death
• Female
• Glucose
• Glutathione
• Graft Survival (drug effects, physiology)
• Humans
• Insulin
• Liver
• Liver Failure (pathology)
• Liver Transplantation (methods)
• Male
• Mannitol
• Middle Aged
• Organ Preservation (instrumentation)
• Organ Preservation Solutions
• Potassium Chloride
• Procaine
• Raffinose
• Retrospective Studies
• Tissue Donors