Impact of Cold Ischemia Time on the Function of Liver Grafts Preserved With Custodiol.

Marina Guitton Rodrigues, Paula Marcela Vilela Castro, Tiago Careli de Almeida, Fernanda Ribeiro Danziere, Francisco Antonio Sergi Filho, Beimar Edmundo Zeballos Sempertegui, Juan Rafel Branez, Leonardo Toledo Mota, Marcelo Perosa de Miranda, Regina Gomes Dos Santos, Tércio Genzini

Journal: Transplantation proceedings 2021;53(2):661-664

PMID: 33139037

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

This study aimed to evaluate how cold ischemia time (CIT) interferes with liver graft function in the first 7 days after surgery for Custodiol (HTK) preserved organs.

METHODS

This retrospective observational study analyzed the medical records of 38 transplantation patients at Hospital Leforte Liberdade, São Paulo, in 2018. The study population was divided into 2 groups (group A, CIT < 8 hours; group B, CIT > 8 hours). Postoperative parameters-such as international normalized ratio, total bilirubin, aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, gamma glutamyl transferase (GGT), lactate dehydrogenase, lactate, creatinine, red blood cell transfusion, need for hemodialysis, use of vasoactive drugs, endotracheal intubation time, length of stay in the intensive care unit (ICU), and length of hospital stay-were compared.

RESULTS

Group A (CIT < 8 hours) presented less need for red blood cell transfusions (odds ratio 0.29; confidence interval 0.06-0.98; P = .04), had a shorter hospital stay (P = .024), and had lower levels of total bilirubin (P = .05) and GGT (P = .05) in the first 7 postoperative days. The other variables showed no statistically significant difference.

CONCLUSION

In livers preserved with Custodiol, CIT > 8 hours generated higher levels of total bilirubin and GGT in the postoperative period, in addition to higher hospital costs; greater need for red blood cell transfusions; and longer hospitalization, including longer stays in the ICU.

Address: General Surgery Residents of Hospital Leforte Liberdade, São Paulo, Brazil. Electronic address: [email protected].; General Surgery Residents of Hospital Leforte Liberdade, São Paulo, Brazil.; Gastrointestinal Surgery Residents of Hospital Leforte Liberdade, São Paulo, Brazil.; Grupo HEPATO-Hepatology, Transplants, and Gastroenterology, São Paulo, Brazil.; Grupo HEPATO-Hepatology, Transplants, and Gastroenterology, São Paulo, Brazil; Liver and Pancreas Transplant Program in Hospital Leforte, São Paulo, Brazil.

DOI: 10.1016/j.transproceed.2020.03.002

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MeSH Terms: Cold Ischemia, Female, Glucose, Humans, Liver Transplantation, Male, Mannitol, Middle Aged, Organ Preservation, Organ Preservation Solutions, Postoperative Complications, Potassium Chloride, Procaine, Reperfusion Injury, Retrospective Studies