Preservation solutions for static cold storage in donation after circulatory death and donation after brain death liver transplantation in the United States.
Journal
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
ISSN: 1527-6473
Titre abrégé: Liver Transpl
Pays: United States
ID NLM: 100909185
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
25
02
2022
received:
11
01
2022
accepted:
15
03
2022
pubmed:
22
3
2022
medline:
10
8
2022
entrez:
21
3
2022
Statut:
ppublish
Résumé
Static cold preservation remains the cornerstone for storing donor livers following procurement; however, the choice between University of Wisconsin solution (UW) and histidine-tryptophan-ketoglutarate solution (HTK) remains controversial. Recent International Liver Transplantation Society (ILTS) guidelines have recommended avoiding HTK for donation after circulatory death (DCD) grafts based on older reports. We studied the latest US adult graft outcomes in three recent eras (2006-2010, 2011-2015, 2016-2020) comparing HTK and UW among 5956 DCD LTs: 3873 (65.0%) used UW and 1944 (32.7%) used HTK. In a total of 82,679 donation after brain death (DBD) liver transplantations (LTs), 63,511 (76.8%) used UW and 15,855 (19.2%) used HTK. The HTK group had higher 1-year and 5-year graft survival rates of 89.7% and 74.3%, respectively, compared with 85.9% and 70.8% in the UW group in the 2016-2020 era (p = 0.005). This difference remained when adjusted for important potential confounders (hazard ratio, 0.78; 95% confidence interval: 0.60, 0.99). There were no differences between groups among DCD LTs in the earlier eras or among DBD LTs in all eras (all p values > 0.05). The latest US data suggest that HTK is at least noninferior to UW for preserving DCD livers. These data support HTK use in DCD LT and contradict ILTS guidance.
Identifiants
pubmed: 35313073
doi: 10.1002/lt.26457
pmc: PMC9544683
pii: 01445473-202209000-00011
doi:
Substances chimiques
Insulin
0
Organ Preservation Solutions
0
University of Wisconsin-lactobionate solution
0
Allopurinol
63CZ7GJN5I
Potassium Chloride
660YQ98I10
Glutathione
GAN16C9B8O
Glucose
IY9XDZ35W2
Adenosine
K72T3FS567
Raffinose
N5O3QU595M
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1454-1462Subventions
Organisme : NIDDK NIH HHS
ID : T32 DK007074
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 The Authors. Liver Transplantation published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.
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