D'Alessandro A M, Kalayoglu M, Sollinger H W, Pirsch J D, Southard J H, Belzer F O
Department of Surgery, University of Wisconsin School of Medicine, Madison.
Arch Pathol Lab Med. 1991 Mar;115(3):306-10.
A retrospective analysis of all organs that were preserved with University of Wisconsin solution was undertaken to assess the impact of this solution on early allograft function. From May 1987 until June 1990, 181 livers, 92 pancreata, and 92 kidneys were preserved with University of Wisconsin solution for extended periods of time. The mean (+/- SD) preservation times were as follows: liver, 12.6 +/- 4.5 hours; pancreas, 16.7 +/- 4.4 hours; and kidney, 18.3 +/- 4.3 hours. The overall rate of primary nonfunction and hepatic artery thrombosis were 6.1% and 3.9%, respectively. No differences in the rates of primary nonfunction and hepatic artery thrombosis were noted for combined liver-pancreas procurement vs isolated liver retrievals or when reduced-size liver transplants were compared with nonreduced liver transplants. Likewise, no difference in primary nonfunction or hepatic artery thrombosis was seen in livers that were preserved for less than 6, 6 to 12, and greater than 12 hours. However, serum aminotransferase levels and prothrombin times were lower on the first postoperative day in livers that were preserved for less than 6 hours when compared with 6 to 12 or greater than 12 hours. Early pancreatic allograft function was also excellent for up to 24 hours of cold-storage preservation. All patients were immediately insulin independent, and there were no cases of initial nonfunction or graft pancreatitis. There were only two cases (2.2%) of pancreatic vascular thrombosis in this series. No difference in pancreatic function was noted for organs that were preserved for less than 6, 6 to 12, or greater than 12 hours. Likewise, renal allograft function was excellent, with only two patients (2.2%) requiring postoperative hemodialysis. The actuarial 1-month patient survival for liver and pancreas-kidney transplant recipients was 91.5% and 98.9%, respectively. Actuarial 1-month allograft survival for liver, pancreas, and kidney transplants was 83.0%, 96.7%, and 97.8%, respectively. In conclusion, University of Wisconsin solution represents a significant advancement in cold-storage organ preservation and is ideally suited as a universal intra-abdominal aortic-flush and cold-storage solution.
对所有采用威斯康星大学溶液保存的器官进行了回顾性分析，以评估该溶液对早期移植器官功能的影响。从1987年5月至1990年6月，181例肝脏、92例胰腺和92例肾脏采用威斯康星大学溶液进行了长时间保存。平均（±标准差）保存时间如下：肝脏，12.6±4.5小时；胰腺，16.7±4.4小时；肾脏，18.3±4.3小时。原发性无功能和肝动脉血栓形成的总体发生率分别为6.1%和3.9%。联合肝脏-胰腺获取与单独肝脏获取相比，或缩小体积肝移植与非缩小体积肝移植相比，原发性无功能和肝动脉血栓形成的发生率无差异。同样，保存时间少于6小时、6至12小时和大于12小时的肝脏，在原发性无功能或肝动脉血栓形成方面未见差异。然而，与保存6至12小时或大于12小时的肝脏相比，保存时间少于6小时的肝脏术后第一天血清转氨酶水平和凝血酶原时间较低。早期胰腺移植器官功能在长达24小时的冷藏保存中也非常出色。所有患者术后立即无需胰岛素，且无初始无功能或移植胰腺炎病例。该系列中仅出现2例（2.2%）胰腺血管血栓形成。保存时间少于6小时、6至12小时或大于12小时的器官在胰腺功能方面未见差异。同样，肾移植器官功能良好，仅2例（2.2%）患者术后需要血液透析。肝移植和胰肾联合移植受者的1个月实际生存率分别为91.5%和98.9%。肝、胰和肾移植的1个月实际移植物生存率分别为83.0%、96.7%和97.8%。总之，威斯康星大学溶液代表了冷藏器官保存方面的重大进展，非常适合作为通用的腹主动脉冲洗和冷藏溶液。
