Combined Flush With Histidine-Tryptophan-Ketoglutarate and University of Wisconsin Solutions in Liver Transplantation: Preliminary Results

被引:6
作者
Leon Diaz, F. J. [1 ,2 ]
Fernandez Aguilar, J. L. [1 ,2 ]
Nicolas de Cabo, S. [2 ]
Perez Reyes, M. [2 ]
Sanchez Perez, B. [2 ]
Montiel Casado, C. [2 ]
Perez Daga, J. A. [2 ]
Aranda Narvaez, J. M. [2 ]
Suarez Munoz, M. A. [2 ]
Arenas Gonzalez, F. [2 ]
Florez Rias, M. M. [3 ]
Pelaez Angulo, J. L. [3 ]
Santoyo Santoyo, J. [1 ,2 ]
机构
[1] Univ Malaga, Fac Med, Malaga, Spain
[2] Reg Hosp, Liver Transplant Unit, Dept Surg, Ave Carlos Haya S-N, Malaga 29010, Spain
[3] Reg Hosp, Dept Pathol Anat, Malaga, Spain
关键词
PRESERVATION; BIOPSIES; INJURY;
D O I
10.1016/j.transproceed.2017.12.033
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction. Ischemia reperfusion injury (IRI) is the main cause of early allograft dysfunction (EAD) and subsequent primary allograft failure (PAF). Objectives. The purpose of this study is to compare IRI, EAD, and PAF in liver transplantation in a cohort of patients perfused with histidine-tryptophan-ketoglutarate (HTK) solution and University of Wisconsin (UW) solution versus HTK alone. Methods. A randomized trial was performed to compare outcomes in liver recipients who underwent transplantation surgery in the University Regional Hospital of Malaga, Spain. Forty patients were randomized to two groups. Primary endpoints included IRI, EAD, PAF, re-intervention, acute cellular rejection, retransplantation, arterial complications, and biliary complications at postoperative day 90. Results. Postoperative glutamic oxaloacetic transaminase (1869.15 +/- 1559.75 UI/L vs. 953.15 +/- 777.27 UI/L; P = .004) and glutamic pyruvic transaminase (1333.60 +/- 1115.49 U/L vs. 721.70 +/- 725.02 U/L; P = .023) were significantly higher in patients perfused with HTK alone. A clear tendency was observed in recipients perfused with HTK alone to present moderate to severe IRI (7 patients in the HTK + UW solution group vs. 15 patients in the HTK-alone solution group; P = .06), EAD (0 patients in the HTK + UW solution group vs. 0 patients in the HTK-alone solution group; P = .76), and PAF (3 patients in the HTK + UW solution group vs. 8 patients in the HTK-alone solution group; P = .15). Conclusions. Initial perfusion with HTK solution followed by UW solution in liver transplantation improves early liver function as compared to perfusion with HTK alone.
引用
收藏
页码:539 / 542
页数:4
相关论文
共 13 条
[1]   Quantitative evaluation of histological features in ''time-zero'' liver allograft biopsies as predictors of rejection or graft failure: Receiver-operating characteristic analysis application [J].
Abraham, S ;
Furth, EE .
HUMAN PATHOLOGY, 1996, 27 (10) :1077-1084
[2]   Compared Efficacy of Preservation Solutions in Liver Transplantation: A Long-Term Graft Outcome Study From the European Liver Transplant Registry [J].
Adam, R. ;
Delvart, V. ;
Karam, V. ;
Ducerf, C. ;
Navarro, F. ;
Letoublon, C. ;
Belghiti, J. ;
Pezet, D. ;
Castaing, D. ;
Le Treut, Y. P. ;
Gugenheim, J. ;
Bachellier, P. ;
Pirenne, J. ;
Muiesan, P. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2015, 15 (02) :395-406
[3]   Analysis of Ischemia/Reperfusion Injury in Time-Zero Biopsies Predicts Liver Allograft Outcomes [J].
Ali, Jason M. ;
Davies, Susan E. ;
Brais, Rebecca J. ;
Randle, Lucy V. ;
Klinck, John R. ;
Allison, Michael E. D. ;
Chen, Yining ;
Pasea, Laura ;
Harper, Simon F. J. ;
Pettigrew, Gavin J. .
LIVER TRANSPLANTATION, 2015, 21 (04) :487-499
[4]   PRESERVATION AND REPERFUSION INJURIES IN LIVER ALLOGRAFTS - AN OVERVIEW AND SYNTHESIS OF CURRENT STUDIES [J].
CLAVIEN, PA ;
HARVEY, PRC ;
STRASBERG, SM .
TRANSPLANTATION, 1992, 53 (05) :957-978
[5]   Preservation injury: Mechanisms, prevention and consequences [J].
Jaeschke, H .
JOURNAL OF HEPATOLOGY, 1996, 25 (05) :774-780
[6]   Liver transplantation using Donation after Cardiac Death donors [J].
Monbaliu, Diethard ;
Pirenne, Jacques ;
Talbot, David .
JOURNAL OF HEPATOLOGY, 2012, 56 (02) :474-485
[7]   Comparison of histidine-tryptophan-ketoglutarate and University of Wisconsin in living-donor liver transplantation [J].
Moray, G. ;
Sevmis, S. ;
Karakayali, F. Y. ;
Gorur, S. K. ;
Haberal, M. .
TRANSPLANTATION PROCEEDINGS, 2006, 38 (10) :3572-3575
[8]   Improved microcirculation by low-viscosity histidine- tryptophan-ketoglutarate graft flush and subsequent cold storage in University of Wisconsin solution: results of an orthotopic rat liver transplantation model [J].
Olschewski, Peter ;
Hunold, Gerhard ;
Eipel, Christian ;
Neumann, Ulf ;
Schoening, Wenzel ;
Schmitz, Volker ;
Vollmar, Brigitte ;
Neuhaus, Peter ;
Puhl, Gero .
TRANSPLANT INTERNATIONAL, 2008, 21 (12) :1175-1180
[9]   Validation of a Current Definition of Early Allograft Dysfunction in Liver Transplant Recipients and Analysis of Risk Factors [J].
Olthoff, Kim M. ;
Kulik, Laura ;
Samstein, Benjamin ;
Kaminski, Mary ;
Abecassis, Michael ;
Emond, Jean ;
Shaked, Abraham ;
Christie, Jason D. .
LIVER TRANSPLANTATION, 2010, 16 (08) :943-949
[10]   Low viscosity histidine-tryptophan-ketoglutarate graft flush improves subsequent extended cold storage in university of Wisconsin solution in an extracorporeal rat liver perfusion and rat liver transplantation model [J].
Puhl, Gero ;
Olschewski, Peter ;
Schoening, Wenzel ;
Hunold, Gerhard ;
Liesaus, Hans-Georg ;
Winkler, Robert ;
Neumann, Ulf P. ;
Schubert, Thomas E. O. ;
Schmitz, Volker ;
Neuhaus, Peter .
LIVER TRANSPLANTATION, 2006, 12 (12) :1841-1849