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Preservation solutions for static cold storage of abdominal allografts: which is best?

Parsons, Ronald F.; Guarrera, James V.

Current Opinion in Organ Transplantation: April 2014 - Volume 19 - Issue 2 - p 100–107
doi: 10.1097/MOT.0000000000000063
ORGAN PRESERVATION AND PROCUREMENT: Edited by Henrik Petrowsky

Purpose of review To update the reader on the recent literature in liver, kidney, pancreas, and intestine static cold preservation, and to identify which solutions are most advantageous for each organ.

Recent findings The comparison of randomized trials of histidine–tryptophan–ketoglutarate (HTK), Celsior, and University of Wisconsin solutions has shown equivalent risk of delayed graft function after kidney transplantation. Similar outcomes have been observed after pancreas preservation with University of Wisconsin, HTK, and Celsior solution. In live-donor liver transplantation, University of Wisconsin and HTK solution have shown equivalent results, whereas in the recent trials of deceased-donor liver transplantation, University of Wisconsin, HTK, and Celsior solutions have shown equivalence. Contrary to the most clinical trials, national registry data in kidney, pancreas, and liver transplantation demonstrate more detrimental effects and earlier graft loss after preservation with HTK versus University of Wisconsin solution. Early outcomes after intestinal transplantation with University of Wisconsin or HTK solution have shown no significant difference and animal studies indicate intraluminal preservation may be beneficial.

Summary The University of Wisconsin solution is the standard criterion static cold preservation for the procurement of liver, kidney, pancreas, and intestine. University of Wisconsin, HTK, and Celsior solutions all provide similar allograft outcomes in most clinical trials, but subtle differences have become more apparent in the recent studies and registry reports.

Department of Surgery, Columbia University College of Physicians and Surgeons, Center for Liver Disease and Transplantation, New York, New York, USA

Correspondence to James V. Guarrera, MD, FACS, Associate Professor of Surgery, Columbia University Medical Center, Center for Liver Disease and Transplantation, 622 West 168th Street, PH 14 Center, Room 202, New York, NY 10032, USA. Tel: +1 212 305 4199; fax: +1 212 305 4343; e-mail: jjg46@cumc.columbia.edu

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins