Liver grafts from ECD can be used to dramatically reduce wait list time with outcomes comparable to those for SD without resorting to living donor liver transplantation.
See Editorial on Page 196University of Wisconsin solution (UW) is the standard preservation solution in cadaveric liver, kidney, pancreas, and small bowel transplantation. The effectiveness of this solution has been demonstrated and has revolutionized the field of transplant surgery. Several competing preservation solutions have been developed, and studies comparing these solutions to UW are ongoing. Histidine-tryptophan-ketoglutarate preservation solution (HTK) was developed in the 1970s as a cardioplegia solution and has recently been used routinely by many centers in kidney, liver, and pancreas preservation.1-8 The composition of these solutions has been described in detail previously. UW was developed by Folkert O. Belzer and is based upon three philosophies: 1) osmotic concentration maintained by metabolically inert substrates, 2) additional administration of the colloid carrier hydroxyethylstarch (HES), and 3) addition of oxygen radical scavengers. UW provides organ tolerance to long cold Abbreviations: HTK, Histidine-tryptophan-ketoglutarate solution; UW, University of Wisconsin solution. Address reprint requests to Dr.
Mortality among patients hospitalized for COVID‐19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID‐19, we compared 28‐day mortality between early 2020 (March 1, 2020–June 19, 2020) and late 2020 (June 20, 2020–December 31, 2020). Multivariable logistic regression was used to assess comorbidity‐adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (
p
< .001). Crude 28‐day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46–0.98,
p
= .016). Between the early and late periods, the use of corticosteroids (≥6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%],
p
< .001 and 50/571 [8.8%] vs. 213/402 [52.2%],
p
< .001, respectively), and the use of hydroxychloroquine and IL‐6/IL‐6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%],
p
< .001 and 73/571 [12.8%] vs. 5/402 [1.2%],
p
< .001, respectively). Mortality among SOTR hospitalized for COVID‐19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study.
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