Kiyoshi Takano de Saidneuy Aldo Elias, Bruno de Rezende Marcelo, Rogerio de Oliveira Salvalaggio Paolo
Imperial Charity Hospital, Florianópolis, Brazil; Albert Einstein Israelite Hospital, São Paulo, Brazil.
Albert Einstein Israelite Hospital, São Paulo, Brazil.
Transplant Proc. 2020 Jun;52(5):1262-1264. doi: 10.1016/j.transproceed.2020.01.172. Epub 2020 Jun 3.
The Institut Georges Lopez 1 (IGL-1) solution was developed to improve the outcomes of solid organ transplantation. Nevertheless, follow-up of liver transplants using IGL-1-preserved organs is still scarce.
To compare morbidity, postoperative complications, and early survival between liver grafts perfused with IGL-1 and those perfused with histidine-tryptophan-ketoglutarate (HTK) solutions.
Prospective liver grafts perfused with IGL-1 (n = 65) were paired with a historical control group of recipients whose grafts were preserved with HTK solution (n = 130). The primary endpoint was the sum of the incidence of primary graft dysfunction (PGD) and primary graft nonfunction (PGNF). Secondary endpoints included resource utilization, complications, and survival analysis.
In the HTK group, 52 patients (40%) exhibited either PGD or PGNF, compared to 20 patients (31%) in the IGL-1 group (P = .208). Patients from the HTK group had higher mean values for cryoprecipitate transfusion (P = .0064), first day serum lactate (P = .0099), higher incidence of vascular complications (11% vs 2% in the IGL-1 group; P = .0226), but a lower incidence of infection (7% vs 28% in the IGL-1 group; P < .0001). The IGL-1 group presented a lower mean aspartate aminotransferase and alanine aminotransferase (ALT) on the first and second postoperative day and a lower ALT on the seventh day. Recipients of grafts perfused with IGL-1 had a better early survival than those whose grafts were perfused with HTK.
Both solutions are safe and present good results. Grafts perfused with IGL-1 showed decreased enzymatic peaks and better short-term survival rates than the HTK group. The use of the IGL-1 solution might be preferable.
乔治·洛佩斯研究所1号（IGL-1）溶液旨在改善实体器官移植的效果。然而，关于使用IGL-1保存器官的肝移植随访仍然很少。
比较用IGL-1灌注的肝移植与用组氨酸-色氨酸-酮戊二酸（HTK）溶液灌注的肝移植的发病率、术后并发症和早期生存率。
将用IGL-1灌注的前瞻性肝移植（n = 65）与用HTK溶液保存移植物的历史对照组（n = 130）进行配对。主要终点是原发性移植功能障碍（PGD）和原发性移植无功能（PGNF）的发生率之和。次要终点包括资源利用、并发症和生存分析。
在HTK组中，52例患者（40%）出现PGD或PGNF，而IGL-1组为20例患者（31%）（P = 0.208）。HTK组患者的冷沉淀输血平均值更高（P = 0.0064），第一天血清乳酸值更高（P = 0.0099），血管并发症发生率更高（IGL-1组为11%，HTK组为2%；P = 0.0226），但感染发生率更低（IGL-1组为7%，HTK组为28%；P < 0.0001）。IGL-1组在术后第一天和第二天的平均天冬氨酸转氨酶和丙氨酸转氨酶（ALT）较低，第七天的ALT也较低。用IGL-1灌注移植物的受者早期生存率高于用HTK灌注移植物的受者。
两种溶液都是安全的，效果良好。与HTK组相比，用IGL-1灌注的移植物酶峰降低，短期生存率更高。使用IGL-1溶液可能更可取。
