OUTCOMES OF LIVER TRANSPLANTATION I

F. Dondéro¹, F. Durand², D. Sommacale¹, C. Francoz², S. Dokmak¹, J.-. Belghiti^3
1Hbp Surgery & Liver Transplantation, Beaujon Hospital, Clichy/FRANCE, ²Hepatology, beaujon hospital, clichy/FRANCE, ³Hpb Surgery & Liver Transplantation, Beaujon Hospital, clichy/FRANCE

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Introduction: IGL-1 preservation solution is characterized by (1) inversion of K+ and Na+ concentrations compared to the University Wisconsin (UW) solution, (2) polyethylene glycol 35 (PEG 35) substitution for hydroxyl-ethyl starch and (3) a lower viscosity. Only preliminary data have been reported yet with this solution in liver transplantation (LT). The aim of this controlled study was to compare the safety and efficacy of IGL-1 solution to that of and University of Wisconsin (UW) solutions in LT. Patients/methods: From June 2007 and July 2008, 132 consecutive deceased donor allografts were transplanted at our center. During this period, preservation solution, either IGL-1 or UW, was randomly assigned on a 1:2 basis. Eighty four grafts were procured using UW and 48 using IGL-1. Variables concerning donors and recipients were collected. Postoperative blood tests were analyzed at postoperative days (POD) 1,3,5,7,10 and 30. Early and delayed biliary and vascular complications were also analyzed. Results: IGL-1 and UW groups were comparable for donor and recipients characteristics. The indication for LT, recipient’s age (47 vs 49 yr), sex, MELD score (17.2 vs 18.9), cold ischemia time (486±104 vs 487±115 min) and total operating time (437±115 vs 445±107 min) were similar in the 2 groups groups. The proportion of fatty liver grafts was also comparable in the 2 groups (37% vs 39%). Mean serum bilirubin level, prothrombin index and serum ALT were similar in both groups on POD 1, 7 and 30. The rate of primary nonfunction was similar with IGL-1 and UW (2% for both). Early retransplantation was needed in 5 patients in the UW and in 3 patients in the IGL-1 group. Biliary complication rates were similar in the 2 groups (11% and 9%). Finally, the rate of arterial complications was identical in the both groups (6% vs 7%). For 1 liver graft procurements, the cost related to preservation solution was markedly lower for IGL-1 compared to UW solutions (143,600 vs 231,800 US$). Conclusions: The results of this randomized study strongly suggest that the efficacy and safety of IGL-1 preservation solution are comparable to those of the reference UW preservation solution but with a more than 60% difference with respect to costs.

Disclosure: All authors have declared no conflicts of interest.