Outcomes using two preservation solutions (UW/HTK) in liver transplantation from brain death donors
Keywords: liver transplantation, cost-benefit analysis, Organ preservation solutions
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 MAT 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.
Más información
Título según WOS: | Outcomes using two preservation solutions (UW/HTK) in liver transplantation from brain death donors |
Título de la Revista: | REVISTA MEDICA DE CHILE |
Volumen: | 142 |
Número: | 10 |
Editorial: | Sociedad Médica de Santiago |
Fecha de publicación: | 2014 |
Página de inicio: | 1229 |
Página final: | + |
Idioma: | Spanish |
Notas: | ISI |