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Celsior Versus University of Wisconsin Preserving Solutions for Liver Transplantation: Postreperfusion Syndrome and Outcome of a 5-Year Prospective Randomized Controlled Study

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Abstract

Background

Celsior solution (CS) is a high-sodium, low-potassium, low-viscosity extracellular solution that has been used for liver graft preservation in recent years, although experience with it is still limited. We performed an open-label randomized active-controlled trial comparing CS with the University of Wisconsin solution (UW) for liver transplantation (LT), with a follow-up period of 5 years.

Methods

Adult transplant recipients (n = 102) were prospectively randomized to receive either CS (n = 51) or UW (n = 51). The two groups were comparable with respect to donor and recipient characteristics. The primary outcome measure was the incidence of postreperfusion syndrome (PRS). Secondary outcome measures included primary nonfunction (PNF) or primary dysfunction (PDF), liver retransplantation, and graft and patient survival. Other secondary outcome measures were days in the intensive care unit (ICU) and the rates of acute rejection, chronic rejection, infectious complications, postoperative reoperations, and vascular and biliary complications.

Results

In all, 14 posttransplant variables revealed no significant differences between the groups. There were no cases of PNF or PDF. The incidence of PRS was 5.9% in the CS group and 21.6% in the UW group (P = 0.041). After reperfusion, CS revealed greater control of serum potassium (P = 0.015), magnesium levels (P = 0.005), and plasma glucose (P = 0.042) than UW. Respective patient survivals at 3, 12, and 60 months were 95.7, 87.2, and 82.0% for the CS group and 95.7, 83.3, and 66.6% for the UW group (P = 0.123).

Conclusions

While retaining the same degree of safety and effectiveness as UW for LT, CS may yield postliver graft reperfusion benefits, as shown in this study by a significant reduction in the incidence of PRS and greater metabolic control.

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Acknowledgments

This work was supported by the Gobierno de Aragón (grants B40 and PI036/09) and by F.I.S. from Instituto de Salud Carlos III (grant RD06/0013/1017).

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, University of Zaragoza, Domingo Miral s/n, 50009, Zaragoza, Spain

    Francisco A. García-Gil, Antonio Güemes & Pablo Royo

  2. Department of Gastroenterology, University Hospital Lozano Blesa, C/San Juan Bosco, 50009, Zaragoza, Spain

    María T. Serrano, Vanesa Bernal, Ana Campillo, Carlos Sostres & Miguel A. Simón

  3. Department of Pharmacology and Physiology, University of Zaragoza, Domingo Miral s/n, 50009, Zaragoza, Spain

    Lorena Fuentes-Broto & José J. García

  4. Department of Gastroenterology, Hospital Donostia, CIBERehd, San Sebastian, Spain

    Juan Arenas

  5. Intensive Care Unit, University Hospital Lozano Blesa, C/San Juan Bosco, 50009, Zaragoza, Spain

    Juan J. Araiz

Authors
  1. Francisco A. García-Gil
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Correspondence to Francisco A. García-Gil.

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García-Gil, F.A., Serrano, M.T., Fuentes-Broto, L. et al. Celsior Versus University of Wisconsin Preserving Solutions for Liver Transplantation: Postreperfusion Syndrome and Outcome of a 5-Year Prospective Randomized Controlled Study. World J Surg 35, 1598–1607 (2011). https://doi.org/10.1007/s00268-011-1078-7

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  • DOI: https://doi.org/10.1007/s00268-011-1078-7

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