Introduction The ability to preserve organs prior to transplant is essential to the organ allocation process. Objective The purpose of this study is to describe the functional relationship between cold-ischemia time (CIT) and primary nonfunction (PNF), patient and graft survival in liver transplant. Methods To identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance. Results Twenty-six studies met criteria. Functionally, PNF% = ？6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean？9.89535)2？0.0067663*(CIT Mean？9.89535)3, r2 = .625, , p<.0001. Mean patient survival: 93 % (1 month), 88 % (3 months), 83 % (6 months) and 83 % (12 months). Mean graft survival: 85.9 % (1 month), 80.5 % (3 months), 78.1 % (6 months) and 76.8 % (12 months). Maximum patient and graft survival occurred with CITs between 7.5–12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches. Conclusion The results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ.
References
[1]
Pedotti P, Cardillo M, Rigotti P, Gerunda G, Merenda R, et al. (2004) A comparative prospective study of two available solutions for kidney and liver preservation. Transplantation 77: 1540–1545.
[2]
Ploeg RJ, D'Alessandro AM, Knechtle SJ, Stegall MD, Pirsch JD, et al. (1993) Risk factors for primary dysfunction after liver transplantation–a multivariate analysis. Transplantation 55: 807–813.
[3]
Ploeg RJ, D'Alessandro AM, Hoffmann RM, Eckhoff D, Isaacs R, et al. (1993) Impact of donor factors and preservation on function and survival after liver transplantation. Transplantation Proceedings 25: 3031–3033.
[4]
Brooks B, Levy M, Jennings L, Abbasoglu O, Vodapally M, et al. (1996) Influence of donor and recipient gender on the outcome of liver transplantation. Transplantation 62: 1784–1787.
[5]
Cacciarelli TV, Dvorchik I, Mazariegos GV, Gerber D, Jain AB, et al. (1999) An analysis of pretransplantation variables associated with long-term allograft outcome in pediatric liver transplant recipients receiving primary tacrolimus (FK506) therapy. Transplantation 68: 650–655.
[6]
Deschenes M, Belle SH, Krom RA, Zetterman RK, Lake JR (1998) Early allograft dysfunction after liver transplantation: a definition and predictors of outcome. National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Transplantation 66: 302–310.
[7]
Greig PD, Forster J, Superina RA, Strasberg SM, Mohamed M, et al. (1990) Donor-specific factors predict graft function following liver transplantation. Transplantation Proceedings 22: 2072–2073.
[8]
Gruenberger T, WSGFBMHWRESRM F (1996) Prediction of graft dysfunction by analysis of liver biopsies after cold storage. Transplant International 9: S132–134.
[9]
Gonzalez FX, Rimola A, Grande L, Antolin M, Garcia-Valdecasas JC, et al. (1994) Predictive factors of early postoperative graft function in human liver transplantation. Hepatology 20: 565–573.
[10]
Mor E, Klintmalm GB, Gonwa TA, Solomon H, Holman MJ, et al. (1992) The use of marginal donors for liver transplantation. A retrospective study of 365 liver donors. Transplantation 53: 383–386.
[11]
Maring J, KIZJKKTVES MJ (1997) Poor initial graft function after orthotopic liver transplantation: can it be predicted and does it affect outcome? An analysis of 125 adult primary transplantations. Clinical Transplantation 11: 373–379.
[12]
Strasberg SM, Howard TK, Molmenti EP, Hertl M (1994) Selecting the donor liver: risk factors for poor function after orthotopic liver transplantation. [comment]. [Review] [60 refs]. Hepatology 20: 829–838.
[13]
Totsuka E, Fung J, Lee M, Ishii T, Umehara M, et al. (2002) Influence of cold ischemia time and graft transport distance on postoperative outcome in human liver transplantation. Surgery Today 32: 792–799.
[14]
Stahl JE, Kong N, Shechter SM, Schaefer AJ, Roberts MS (2005) A methodological framework for optimally re-organizing liver transplant regions. MDM 25: 35–46.
[15]
Chalmers THS Jr, Blackburn B, Silverman B, Schroeder B, et al. (1981) A method for assessing the quality of a randomized control trial. Controlled Clinical Trials 2: 31–49.
[16]
Pettiti D (1994) Meta-analysis, Decision Analysis, and Cost-effectiveness analysis. New York: Oxford University Press.
[17]
Jain A, Mohanka R, Orloff M, Abt P, Kashyap R, et al. (2006) University of Wisconsin versus histidine-tryptophan-ketoglutarate for tissue preservation in live-donor liver transplantation. Exp Clin Transplant 4: 451–457.
[18]
Fernandez-Merino J, Nuno-Garza J, Lopez-Hervas P, Lopez-Buenadicha A, Quijano-Collazo Y, et al. (2003) Influence of Ischemia and Surgery Times on Development of Primary Dysfunction Liver Transplant in Patients. Transplant Proceedings 35: 1439–1441.
[19]
Yanaga K, Tzakis AG, Starzl TE (1989) Personal experience with the procurement of 132 liver allografts. Transplant International 2: 137–142.
[20]
Todo S, Nery J, Yanaga K, Podesta L, Gordon RD, et al. (1989) Extended preservation of human liver grafts with UW solution. Jama 261: 711–714.
[21]
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7: 177–188.
[22]
Adam R, Bismuth H, Diamond T, Ducot B, Morino M, et al. (1992) Effect of extended cold ischaemia with UW solution on graft function after liver transplantation. [comment]. Lancet 340: 1373–1376.
[23]
Adam R, Azoulay D, Astarcioglu I, Chiche L, Bao YM, et al. (1993) Limits of the MEGX test in the selection of liver grafts for transplantation. Transplantation Proceedings 25: 1653–1654.
[24]
Adam R, Sanchez C, Astarcioglu I, Bismuth H (1995) Deleterious effect of extended cold ischemia time on the posttransplant outcome of aged livers. Transplantation Proceedings 27: 1181–1183.
[25]
Bennett-Guerrero E, Feierman D, Barclay G, Parides M, Sheiner P, et al. (2001) Preoperative and intraoperative predictors of postoperative morbidity, poor graft function, and early rejection in 190 patients undergoing liver transplantation. Arch Surg 136: 1177–1183.
[26]
Calmus Y, Cynober L, Dousset B, Lim SK, Soubrane O, et al. (1995) Evidence for the detrimental role of proteolysis during liver preservation in humans. Gastroenterology 108: 1510–1516.
[27]
Cofer J, Klintmalm G, Morris C, Solomon H, Watemberg I, et al. (1992) A prospective randomized trial between Euro-Collins and University of Wisconsin solutions as the initial flush in hepatic allograft procurement. Transplantation 53: 995–998.
[28]
Dette K, Knoop M, Langrehr JM, Haller G, Steinmueller T, et al. (1997) Donor MEGX test fails to predict graft function after orthotopic liver transplant. Transplantation Proceedings 29: 376–377.
[29]
Furukawa H, Todo S, Imventarza O, Casavilla A, Wu YM, et al. (1991) Effect of cold ischemia time on the early outcome of human hepatic allografts preserved with UW solution. Transplantation 51: 1000–1004.
[30]
Furukawa H, Todo S, Imventarza O, Wu YM, Scotti C, et al. (1991) Cold ischemia time vs outcome of human liver transplantation using UW solution. Transplantation Proceedings 23: 1550–1551.
[31]
Garcia-Valdecasas JC, Gonzalez FJ, Grande L, Rimola A, Navasa M, et al. (1991) The use of the University of Wisconsin (UW) and Euro-Collins (EC) solutions either alone or in a combined method. Transplant International 5: 77–80.
[32]
Imagawa DK, Olthoff KM, Yersiz H, Shackleton CR, Colquhoun SD, et al. (1996) Rapid en bloc technique for pancreas-liver procurement. Improved early liver function. Transplantation 61: 1605–1609.
[33]
Olthoff KM, Millis JM, Imagawa DK, Nuesse BJ, Derus LJ, et al. (1990) Comparison of UW solution and Euro-Collins solutions for cold preservation of human liver grafts. Transplantation 49: 284–290.
[34]
Piratvisuth T, Tredger JM, Hayllar KA, Williams R (1995) Contribution of true cold and rewarming ischemia times to factors determining outcome after orthotopic liver transplantation. Liver Transplantation & Surgery 1: 296–301.
[35]
Stratta RJ, Wood RP, Langnas AN, Duckworth RM, Markin RS, et al. (1990) The impact of extended preservation on clinical liver transplantation. Transplantation 50: 438–443.
[36]
Takaya S, Doyle H, Todo S, Irish W, Fung JJ, et al. (1995) Reduction of primary nonfunction with prostaglandin E1 after clinical liver transplantation. Transplantation Proceedings 27: 1862–1867.
[37]
Wall WJ, Mimeault R, Grant DR, Bloch M (1990) The use of older donor livers for hepatic transplantation. Transplantation 49: 377–381.
[38]
Woodside KJ, Merion RM, Williams TC (1998) Prospective multivariate analysis of donor monoethylglycine xylidide (MEGX) testing in liver transplantation. Transplantation Society of Michigan Scientific Studies Committee. Clinical Transplantation 12: 43–48.
[39]
de Ville de Goyet J, Hausleithner V, Malaise J, Reding R, Lerut J, et al. (1994) Liver procurement without in situ portal perfusion. A safe procedure for more flexible multiple organ harvesting. Transplantation 57: 1328–1332.
[40]
Adam R, Astarcioglu I, Castaing D, Bismuth H (1991) Ringer's lactate vs serum albumin as a flush solution for UW preserved liver grafts: results of a prospective randomized study. Transplantation Proceedings 23: 2374–2375.
[41]
Cavallari A, Cillo U, Nardo B, Filipponi F, Gringeri E, et al. (2003) A multicenter pilot prospective study comparing Celsior and University of Wisconsin preserving solutions for use in liver transplantation. Liver Transpl 9: 814–821.
[42]
Nardo B, Catena F, Cavallari G, Montalti R, Naro AD, et al. (2001) Randomized clinical study comparing UW and Celsior solution in liver preservation for transplantation: preliminary results. Transplant Proc 33: 870–872.
[43]
Clavien P, Harvey P, Strasberg S (1992) Preservation and reperfusion injuries in liver allografts. An overview and synthesis of current studies. [Review]. Transplantation 53: 957–978.
[44]
Kang K (2002) Mechanism of hepatic ischemia/reperfusion injury and protection against reperfusion injury. Review. Transplantation Proceedings 34: 2659–2661.
[45]
Ohkohchi N (2002) Mechanisms of preservation and ischemic/reperfusion injury in liver transplantation. [Review]. Transplantation Proceedings 34: 2670–2673.
[46]
Kuss R, Bourge P (1992) An Illustrated History of Organ Transplantation: The Great Adventure of the Century. Rueil-Malmaison, France: Laboratoires Sandoz.
[47]
Collins G, Bravo-shugarman M, Terasaki P (1969) Kidney preservation for transportation; initial perfusion and 30 hours' ice storage. Lancet II: 1219–1220.
[48]
Wahlberg J, Love R, Landegaard L (1987) Seventy two hour preservation of the canine pancreas. Transplantation 43: 5–8.
[49]
Menasche P, Termignon J, Pradier F, Grousset C, Mouas C, et al. (1994) Experimental evaluation of Celsior, a new heart preservation solution. Eur J Cardiothorac Surg 8: 207–213.
[50]
Burdelski M, Oellerich M, Lamesch P, Raude E, Ringe B, et al. (1987) Evaluation of quantitative liver function tests in liver donors. Transplantation Proceedings 19: 3838–3839.
[51]
Carraro P, Varagnolo MC, Cillo U, Tedeschi U, Burra P, et al. (1995) Laboratory test scores to aid identification of primary nonfunction of liver transplants. Clinical Chemistry 41: 471.
[52]
Cillo U, Tedeschi U, Carraro P, Burra P, Varagnolo M, et al. (1994) Early predictive markers of irreversible graft dysfunction after liver transplantation. Transplantation Proceedings 26: 3599–3601.
[53]
Haller GW, Langrehr JM, Blumhardt G, Platz KP, Muller A, et al. (1995) Factors relevant to the development of primary dysfunction in liver allografts. Transplantation Proceedings 27: 1192.
[54]
Makowka L, Gordon RD, Todo S, Ohkohchi N, Marsh JW, et al. (1987) Analysis of donor criteria for the prediction of outcome in clinical liver transplantation. Transplantation Proceedings 19: 2378–2382.
[55]
Oellerich M, Hartmann H, Ringe B, Burdelski M, Lautz HU, et al. (1993) Assessment of prognosis in transplant candidates by use of the Pugh-MEGX score. Transplantation Proceedings 25: 1116–1119.
[56]
Trotter J, Osgood M (2004) MELD scores of liver transplant recipients according to size of waiting list: impact of organ allocation and patient outcomes. JAMA 291: 1871–1874.
[57]
Nardo B, Bertelli R, Montalti R, Beltempo P, Puviani L, et al. (2005) Preliminary results of a clinical randomized study comparing Celsior and HTK solutions in liver preservation for transplantation. Transplant Proc 37: 320–322.
[58]
Cofer JB, Klintmalm GB, Howard TK, Morris CV, Husberg BS, et al. (1990) A comparison of UW with Eurocollins preservation solution in liver transplantation. Transplantation 49: 1088–1093.
[59]
Garcia-Valdecasas JC, Gonzalez FJ, Grande L, Rimola A, Fuster J, et al. (1992) Study of liver preservation: efficacy of a combined method using the UW solution. Transplantation Proceedings 24: 130–132.
