Compared efficacy of preservation solutions on the outcome of liver transplantation: Meta-analysis

Abstract

AIMTo compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations.METHODSA systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31st, 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions. Fifteen RCTs (1830 livers) were included; the primary outcomes were primary non-function (PNF) and one-year post-transplant graft survival (OGS-1).RESULTSAll trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1 (RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1 (RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes.CONCLUSIONAlternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted.

Effects of thiopental in cold ischemia in liver transplantation: An experimental study

“…The most important factor affecting success of organ transplantation is protecting against ischemia-reperfusion (I/R) injury and ensuring continued organ viability [8]. With the aim of reducing organ metabolism, subjecting the organ to cold ischemia is an important method to increase viability and posttransplantation success.…”

“…The most common of these include University of Wisconsin (UW) solution, histidine-tryptophan-ketoglutarate (HTK), Celsior (CS), Institut Georges Lopez (IGL-1) Collins, Euro-collins, UW-PEG, Polysol, Kyoto, New Kyoto etc. [8,9].…”

Impact of Hypothermia and Oxygen Deprivation on the Cytoskeleton in Organ Preservation Models

“…UW was used herein as it remains the leading solution used worldwide and has shown to remain on par with the other solutions in terms of organ protection [ 23 ]. Unfortunately, UW is not adapted for cell preservation at 37°C; this condition was thus tested for the sake of thoroughness but could not be used to test the effect of temperature.…”

IGL-1 preservation solution in kidney and pancreas transplantation: A systematic review

“…A recent systematic review of Szilagyi et al concluded that UW, HTK and IGL-1 solutions are associated with nearly equivalent outcomes. [31] Subgroup analyses could not identify any differences between IGL-1 and UW or HTK for primary non function and overall graft survival after one year. Some caution is warranted as only 5 studies were available for inclusion in this systematic review and therefore no firm conclusion can be drawn.…”