Mühlbacher F, Langer F, Mittermayer C
Chirurgische Universitätsklinik Wien, Abteilung für Transplantation, Austria.
Transplant Proc. 1999 Aug;31(5):2069-70. doi: 10.1016/s0041-1345(99)00265-1.
Eurocollins has almost been abandoned because of the glucose disadvantage. UW is certainly the most used preservation solution for livers, kidneys, and pancreases with excellent clinical and experimental preservation data. UW can certainly be considered the current golden standard solution. However, the disadvantage of high viscosity, high price, uneasy handling of many 1-L bags, and the fact that the radical scavenger glutathion cannot be detected in the bags by chemical analysis (presumably due to diffusion) encourage competitors to produce new compounds with better cost to effect ratios. HTK has a firm place in cardiac preservation; by demonstration of equal safety and efficacy in preserving livers and kidneys, at least in the middle and lower range of cold ischemia time, HTK will be sued more frequently, particularly with the consideration of lower price and more easy handling aspects. The suggested high volume perfusion is not really necessary, calculation based on a total volume of 10 L for a multiorgan donor show significant cost reductions. Celsior is current only used for cardiac preservation. Beyond all aspects of conservation and preservation potencies of all these fluids, it must not be forgotten that cold ischemia itself is a risk factor for organ function. Therefore, cold ischemia time should be kept as short as possible. People are willing to accept 24 hours or more cold ischemia time in kidney transplantation because organ failure can be treated by dialysis. In other organs, where immediate organ function is essential, like in clinical heart transplantation, cold ischemia is hardly ever extended beyond 6 hours. Why are hearts and kidneys so different? Very likely, there is no difference, and the outstanding results in living unrelated kidney transplants is mostly due to short cold ischemia time.
由于葡萄糖劣势，欧洲柯林斯液几乎已被弃用。UW液无疑是肝脏、肾脏和胰腺保存中使用最广泛的保存液，有出色的临床和实验保存数据。UW液当然可被视为当前的金标准溶液。然而，其高粘度、高价格、多个1升袋不易处理的缺点，以及袋中无法通过化学分析检测到自由基清除剂谷胱甘肽（可能是由于扩散），促使竞争对手研发成本效益比更佳的新化合物。HTK液在心脏保存方面有稳固地位；通过证明在肝脏和肾脏保存中具有同等安全性和有效性，至少在冷缺血时间的中低范围内，HTK液将被更频繁地使用，尤其是考虑到其价格更低且操作更简便。建议的高容量灌注并非真正必要，基于多器官供体10升总体积的计算显示成本显著降低。赛尔西奥液目前仅用于心脏保存。在考虑所有这些液体的保存和保护效力的所有方面之外，绝不能忘记冷缺血本身就是器官功能的一个风险因素。因此，冷缺血时间应尽可能缩短。在肾移植中人们愿意接受24小时或更长时间的冷缺血时间，因为器官衰竭可通过透析治疗。在其他器官中，立即恢复器官功能至关重要，如在临床心脏移植中，冷缺血时间几乎从不超过6小时。为什么心脏和肾脏如此不同呢？很可能并无差异，活体非亲属肾移植的出色结果主要归因于短冷缺血时间。
