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

Transplant Proc. 2021 Mar;53(2):661-664. doi: 10.1016/j.transproceed.2020.03.002. Epub 2020 Nov 1.

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.

Publication types

  • Observational Study

MeSH terms

  • Cold Ischemia / methods*
  • Female
  • Glucose / pharmacology
  • Humans
  • Liver Transplantation / methods*
  • Male
  • Mannitol / pharmacology
  • Middle Aged
  • Organ Preservation / adverse effects
  • Organ Preservation / methods*
  • Organ Preservation Solutions / pharmacology*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Potassium Chloride / pharmacology
  • Procaine / pharmacology
  • Reperfusion Injury / etiology
  • Retrospective Studies

Substances

  • Bretschneider cardioplegic solution
  • Organ Preservation Solutions
  • Mannitol
  • Procaine
  • Potassium Chloride
  • Glucose