Comparable outcome of liver transplantation with Histidine-Tryptophan-Ketoglutarate vs. University of Wisconsin preservation solution: a retrospective observational double-center trial

BMC Gastroenterology

Research Article

Christian Krauth¹  Volker Amelung¹  Felix Braun²  Benedikt Reichert²  Harald Schrem³  Jürgen Klempnauer³  Frank Lehner³  Jill Gwiasda³  Alexander Kaltenborn⁴ 

[1] Department Health Economics and Health Systems Research of the Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany;Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany;Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Department of General, Visceral and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Department of Trauma and Orthopedic Surgery, Federal Armed Forces Hospital Westerstede, Westerstede, Germany;

关键词: Organ procurement;    Risk-adjusted analysis;    Prolonged cold ischemic time;    Biliary complications;    Economic evaluation;   

DOI  :  10.1186/1471-230X-14-169

 received in 2014-03-01, accepted in 2014-09-12,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe question of whether the choice of preservation solution affects outcome after liver transplantation is still not satisfactorily answered. The purpose of this study is to examine the preservation solutions’ impact on outcome after liver transplantation.MethodsA double-center retrospective study of short- and long-term results of 3134 consecutive liver transplantations with follow-up periods up to 23 years was performed applying multivariate, risk-adjusted analyses with a subset for living-donor transplants, pediatric transplants and cases with prolonged cold ischemic times. An additional focus was put on biliary complications. The primary study endpoints were short- and long-term patient survival and death-censored graft survival. Secondary study endpoints were the occurrence of post-transplant complications, the necessity of operative revisions, the length of hospital stay, and the length of intensive care unit stay.ResultsAlthough long-term graft survival appears to be increased by Histidine-Tryptophan-Ketoglutarate-use (p = 0.018), this effect could not be confirmed in risk-adjusted analysis (p = 0.641). Multivariate regression analysis revealed that 3-month mortality (p = 0.120), 3-month graft survival (p = 0.103) and long-term patient survival (p = 0.235) were not influenced by the choice of preservation solution. There was no difference in the occurrence of common complications or necessity of operative revisions after liver transplantation. This was confirmed in subgroup analyses for living donor and pediatric transplantation and cases with prolonged cold ischemic time. Analysis of the preservation solutions’ impact on length of hospital (p = 0.113) and intensive care unit stay (p = 0.481) revealed no significant difference.ConclusionsUniversity of Wisconsin and Histidine-Tryptophan-Ketoglutarate solutions are clinically equivalent. Histidine-Tryptophan-Ketoglutarate solution could have an economically superior profile. The notion that the choice of preservation solution can have an impact on the onset of biliary complications after liver transplantation remains a matter of controversy.

【 授权许可】

CC BY   
© Kaltenborn et al.; licensee BioMed Central Ltd. 2014