Nicoluzzi J, Macri M, Fukushima J, Pereira A
Department of Surgery, Faculty of Medicine, PUC-PR Brazil, Parana, Brazil.
Transplant Proc. 2008 Dec;40(10):3305-7. doi: 10.1016/j.transproceed.2008.05.080.
Celsior solution (CS), which has recently become available, that might theoretically offer a new means for improving graft preservation quality. The present prospective, randomized study was designed to evaluate the efficacy of CS compared with University of Wisconsin (UW) for pancreas allografts. Between January 2001 and January 2007, 88 patients underwent pancreatic transplantation, including the last 30 consecutive simultaneous pancreas kidney patients who were randomly assigned to either CS or UW. There was no case of graft thrombosis in either group. There were 2 cases of pancreatitis in the UW group compared with 1 in the CS group. No case of primary nonfunction occurred in either group. There were 2 cases of early duodenal stump fistulae in the CS group that required transplantectomy, whereas this complication was not observed in the UW group. Relaparotomy in the UW group was required in 3 cases due to infection and treated by close drainage that which, progressed to fatal sepsis in 1 patient. In the UW group with 6 months of follow-up, there were 12 patients insulin free. In the CS group, 6 patients underwent relaparotomy, 3 for transplantectomy and the others for intra-abdominal infection, which was fatal in 2 cases. In the CS group with 6 months of follow-up, there were 10 patients insulin free. Two patients died with functioning grafts. These results provided indirect evidence that CS solution is at least as safe as UW to mitigate postreperfusion graft edema and pancreatitis, as well as graft thrombosis.
最近可用的Celsior溶液(CS),理论上可能提供一种改善移植物保存质量的新方法。本前瞻性随机研究旨在评估CS与威斯康星大学(UW)溶液相比用于胰腺同种异体移植的疗效。在2001年1月至2007年1月期间,88例患者接受了胰腺移植,包括最后连续30例同时进行胰腺肾脏移植的患者,他们被随机分配至CS组或UW组。两组均未发生移植物血栓形成。UW组有2例胰腺炎,而CS组有1例。两组均未发生原发性无功能病例。CS组有2例早期十二指肠残端瘘,需要进行移植切除,而UW组未观察到该并发症。UW组有3例因感染需要再次剖腹手术,通过密切引流治疗,其中1例进展为致命性脓毒症。在UW组6个月的随访中,有12例患者无需胰岛素。在CS组,6例患者进行了再次剖腹手术,3例进行移植切除,其他患者因腹腔内感染,其中2例死亡。在CS组6个月的随访中,有10例患者无需胰岛素。2例患者在移植物功能良好的情况下死亡。这些结果提供了间接证据,表明CS溶液在减轻再灌注后移植物水肿、胰腺炎以及移植物血栓形成方面至少与UW溶液一样安全。