One Hundred Consecutive Liver Transplants Using Institutes Georges Lopez-1 Preservation Solution: Outcomes and Prognostic Factors

• Published in: Transplantation proceedings Vol. 49; no. 4; pp. 848 - 851
• Main Authors: Chedid, M.F, Bosi, H.R, Chedid, A.D, Alvares-da-Silva, M.R, Leipnitz, I, Grezzana-Filho, T.J.M, Reis, M.J, Filho, G.M, Ghissi, A.J, Neto, P.R, de Araujo, A, Arruda, S, Lopes, A.B, Michalczuk, M.T, Backes, A.N, Kruel, C.D.P, Kruel, C.R.P
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2017
• Subjects: Adolescent; Adult; Aged; End Stage Liver Disease - surgery; Female; Graft Survival; Humans; Liver Transplantation - methods; Male; Middle Aged; Organ Preservation - methods; Organ Preservation Solutions; Postoperative Period; Prognosis; Reoperation; Retrospective Studies; Surgery; Time Factors; Warm Ischemia; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2017.01.061

Abstract Background There are only 4 prior studies reporting on outcomes of liver transplantation (LT) using Institutes Georges Lopez-1 (IGL-1) preservation solution. Detection of negative predictors of LT using IGL-1 may help finding strategies to protect selected recipients at higher risk of graft failure and death. Methods Review of all consecutive adult patients who underwent a first whole-graft LT using IGL-1 at authors' institution from 2013 to 2016. Primary end point was graft failure within the first 90 postoperative days (PODs). Graft losses due to any cause (including all deaths with a functioning graft) were recorded as graft failures. Results Of all 100 patients included in this study, 37 were women; median age was 58 years (range 18–71). There were 12 graft losses during the first 90 PODs (including 3 cases of primary nonfunction of the liver allograft), and 10 of the 12 graft losses occurred on first 30 PODs. All 12 patients who experienced graft loss (including 1 patient who underwent liver retransplantation) died within the first 90 PODs. Of the total 100 patients, 14 experienced biliary complications. Univariate analysis revealed prolonged warm ischemic time (WIT) as the only predictor of 90-day graft failure (odds ratio = 23.5, confidence interval = 1.29–430.18, P  = .03). The cutoff by receiver operating characteristic curve for WIT was 38 minutes (area under the curve = 0.70). Positive predictive value for WIT >38 minutes was 94.3%. Conclusions LT using IGL-1 can be performed safely. Similar to prior reports on LT using other preservation solutions, prolonged WIT was associated with adverse outcomes.