Is a Preservation Solution for Living Donor Liver Transplantation Needed? Adding a New Chapter in LDLT!
Abdul Wahab Dogar, Kaleem Ullah, Shams-ud-din, Syed Hasnain Abbas, Azhar Hussain, Abdul Ghaffar, Hafiz Bilal, Siraj-ud-din, Azam Shoaib, Bilal Ahmed, Hamid Raza, Ameer Hamza, Abu Bakar Hafeez Bhatti, Subash Gupta, Sylvester M. Black, Khalid Mumtaz- Transplantation
Background.
Preservation solutions are required for organ viability in deceased donor liver transplantation (LT). However, their role in live donor LT (LDLT) has not been standardized.
Methods.
Eighty adult recipients who underwent right lobe LDLT at the Department of Liver Transplantation Surgery, Gambat, Pakistan, were studied. Based on shorter cold ischemia time and no back table reconstruction work, recipients were assigned to receive “no preservation solution” (cases/non–histidine-tryptophan-ketoglutarate group; n = 40) or “HTK group” (controls; n = 40). Early allograft dysfunction (bilirubin, transaminases, and international normalized ratio), postoperative complications (biliary and vascular), hospital stay, and 1-y survival were reported. The direct cost was also reported.
Results.
Demographics and clinical characteristics were comparable in the 2 groups. Comparing cases versus controls, mean bilirubin, alanine aminotransferase, aspartate aminotransferase, and international normalized ratio on postoperative day 7 were similar in the 2 groups. Five (12.5%) cases and 4 (10%) controls developed early allograft dysfunction (
Conclusion.
In a selected cohort of right lobe LDLT recipients, preservation solutions can be avoided safely with comparable outcomes.