Current status and perspective of liver preservation solutions

A safe and effective preservation solution is a precondition for liver transplantation, which is accepted as the radical treatment for patients with end-stage liver disease. The increasing use of marginal donors and non-heart beating donors as well as the establishment of a national organ allocation...

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Bibliographic Details
Published in:Hepatobiliary & pancreatic diseases international 2006-11, Vol.5 (4), p.490-494
Main Authors: Feng, Xiao-Ning, Xu, Xiao, Zheng, Shu-Sen
Format: Article
Language:English
Subjects:
Adenosine - adverse effects
Allopurinol - adverse effects
Animals
Antibodies
Bile Duct Diseases - etiology
biliary
complication
Disaccharides
Electrolytes
Fructosediphosphates
gene
Glucose - adverse effects
Glutamates
Glutathione - adverse effects
Histidine
Humans
Insulin - adverse effects
Ischemia - etiology
liver
Liver - blood supply
Mannitol - adverse effects
Microcirculation
Organ Preservation Solutions - adverse effects
Potassium Chloride - adverse effects
preservation
Procaine - adverse effects
protective
Raffinose - adverse effects
solution
Tacrolimus
Transformation, Genetic
Tumor Necrosis Factor-alpha - immunology
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Summary:A safe and effective preservation solution is a precondition for liver transplantation, which is accepted as the radical treatment for patients with end-stage liver disease. The increasing use of marginal donors and non-heart beating donors as well as the establishment of a national organ allocation network call for better preservation. New preservation solutions like histidine-tryptophan-ketoglutarate (HTK) solution and Celsior solution have been introduced to liver preservation, and protective gene intervention and other modifications have also been investigated. In this article, we review recent advances in liver preservation solutions. An English-language literature search was conducted using MEDLINE (1990-2005) on liver preservation solution, biliary complication, protective gene and other related subjects. Although the high viscosity of the University of Wisconsin (UW) solution proved harmful to the hepatic microcirculation, three solutions showed equivalent preservation effects. When the cold ischemia time was short, there were no significant differences among the three solutions in the incidence of biliary complications. So far, modifications of preservation solutions have achieved great success. Several types of protective genes like A20, Bcl-2, Bcl-X(L) and HO-1 were reported to have definite liver protective effects. The addition of other substrates like TNF-alpha antibody, tacrolimus (FK506) and fructose-1,6-bisphosphate (FBP) can also improve the preservation effect. However, addition of insulin to UW solution is harmful to the graft. In centers with highly-developed transplantation techniques, HTK and Celsior solutions are acceptable in liver preservation. Protective gene modification and addition of substrates like TNF-alpha antibody, FK506 and FBP are prominent approaches to improve liver preservation.
ISSN:1499-3872