Liver Transplantation Using University of Wisconsin or Celsior Preserving Solutions in the Portal Vein and Euro-Collins in the Aorta

• Published in: Transplantation proceedings 2010-03, Vol.42 (2), p.429-434
• Main Authors: Duca, W.J, da Silva, R.F, Arroyo, P.C, Sgnolf, A, Cabral, C.M, Ayres, D.C, Felício, H.C.C, da Silva, R.d.C.M.A
• Format: Article
• Language: English
• Subjects: Adenosine - therapeutic use; Adolescent; Adult; Aged; Allopurinol - therapeutic use; Aorta, Abdominal - drug effects; Aorta, Abdominal - physiology; Biological and medical sciences; Cadaver; Child; Child, Preschool; Disaccharides - therapeutic use; Electrolytes - therapeutic use; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glutamates - therapeutic use; Glutathione - therapeutic use; Histidine - therapeutic use; Humans; Hypertonic Solutions - therapeutic use; Immunosuppressive Agents - therapeutic use; Insulin - therapeutic use; Liver Failure - surgery; Liver Transplantation - immunology; Liver Transplantation - methods; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Mannitol - therapeutic use; Medical sciences; Middle Aged; Organ Preservation - methods; Organ Preservation Solutions - therapeutic use; Portal Vein - drug effects; Portal Vein - physiology; Postoperative Complications - epidemiology; Prospective Studies; Raffinose - therapeutic use; Reperfusion Injury - epidemiology; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue Donors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.01.035

Abstract Introduction Orthotopic liver transplantation (OLT) is today the gold standard treatment of the end-stage liver disease. Different solutions are used for graft preservation. Our objective was to compare the results of cadaveric donor OLT, preserved with the University of Wisconsin (UW) or Celsior solutions in the portal vein and Euro-Collins in the aorta. Methods We evaluated retrospectively 72 OLT recipients, including 36 with UW solution (group UW) and 36 with Celsior (group CS). Donors were perfused in situ with 1000 mL UW or Celsior in the portal vein of and 3000 mL of Euro-Collins in the aortia and on the back table managed with 500 mL UW or Celsior in the portal vein, 250 mL in the hepatic artery, and 250 mL in the biliary duct. We evaluated the following variables: donor characteristics, recipient features, intraoperative details, reperfusion injury, and steatosis via a biopsy after reperfusion. We noted grafts with primary nonfunction (PNF), initial poor function (IPF), rejection episodes, biliary duct complications, hepatic artery complications, re-OLT, and recipient death in the first year after OLT. Results The average age was 33.6 years in the UW group versus 41 years in the CS group ( P = .048). There was a longer duration of surgery in the UW group ( P = .001). The other recipient characteristics, ischemia-reperfusion injury, steatosis, PNF, IPF, rejection, re-OLT, and recipient survival were not different. Stenosis of the biliary duct occured in 3 (8.3%) cases in the UW group and 8 (22.2%) in the CS ( P = .19) with hepatic artery thrombosis in 4 (11.1%) CS versus none in the UW group ( P = .11). Conclusion Cadaveric donor OLT showed similar results with organs preserved with UW or Celsior in the portal vein and Euro-Collins in the aorta.