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保存液类型(UW或HTK)对肝移植术后胆管狭窄发生率有影响:一项回顾性研究。

Type of Preservation Solution, UW or HTK, Has an Impact on the Incidence of Biliary Stricture following Liver Transplantation: A Retrospective Study.

作者信息

Karakoyun Rojbin, Romano Antonio, Nordström Johan, Ericzon Bo-Göran, Nowak Greg

机构信息

Division of Transplantation Surgery, CLINTEC, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.

出版信息

J Transplant. 2019 Dec 21;2019:8150736. doi: 10.1155/2019/8150736. eCollection 2019.

Abstract

Organ preservation plays a crucial role in the outcome following solid organ transplantation. The aim of this study was to perform a retrospective outcome analysis following liver transplantation using histidine tryptophan ketoglutarate (HTK) or the University of Wisconsin (UW) solutions for liver graft preservation. We retrospectively reviewed data on adult patients who were liver-transplanted at Karolinska University Hospital between 2007 and 2015. There was evaluation of donor and recipient characteristics, pre- and post-transplant blood chemistry tests, biliary and vascular complications, graft dysfunction and nonfunction, and patient and graft survivals. A total of 433 patients were included in the analyses, with 230 and 203 patients having received livers preserved with HTK and UW, respectively. Mean follow-up was 45 ± 29 months for the HTK group and 42.4 ± 26 for the UW group. There was no difference between the two groups either in terms of patient and graft survival, or of results of postoperative blood chemistry, or incidence of arterial complications, early allograft dysfunction, or primary graft nonfunction. However, the incidence of biliary stricture was higher in the UW group (22.7%) versus the HTK group (13.5%; =0.013). Use of UW and HTK preservation solution in liver transplantation has no impact on patient and graft survival. However, use of HTK solution results in a lower incidence of posttransplant biliary stricture.

摘要

器官保存对实体器官移植后的结果起着至关重要的作用。本研究的目的是对使用组氨酸-色氨酸-酮戊二酸(HTK)或威斯康星大学(UW)溶液保存肝移植供肝后的结果进行回顾性分析。我们回顾性分析了2007年至2015年在卡罗林斯卡大学医院接受肝移植的成年患者的数据。评估了供体和受体的特征、移植前后的血液化学检查、胆道和血管并发症、移植物功能障碍和无功能以及患者和移植物的存活率。共有433例患者纳入分析,其中分别有230例和203例患者接受了用HTK和UW保存的肝脏。HTK组的平均随访时间为45±29个月,UW组为42.4±26个月。两组在患者和移植物存活率、术后血液化学结果、动脉并发症发生率、早期移植物功能障碍或原发性移植物无功能方面均无差异。然而,UW组的胆道狭窄发生率(22.7%)高于HTK组(13.5%;P=0.013)。在肝移植中使用UW和HTK保存液对患者和移植物存活率没有影响。然而,使用HTK溶液可降低移植后胆道狭窄的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16d8/6942894/483fe8a9845d/JTRANS2019-8150736.001.jpg

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