Impact of graft preservation solutions for liver transplantation on early cytokine release and postoperative organ dysfunctions. A pilot study - 15/12/17

Doi : 10.1016/j.clinre.2016.12.011

H. Brisson ^a,^b,^⁎ , C. Arbelot ^a, A. Monsel ^a, C. Parisot ^b, M. Girard ^a, E. Savier ^c,^d, C. Vezinet ^a, Q. Lu ^a, J.-C. Vaillant ^c, J.-L. Golmard ^e, G. Gorochov ^b, O. Langeron ^a, J.-J. Rouby ^a
Members of the Pitié-Salpêtrière Liver Transplantation Study Group
G. Rousseau ^f, J.-M. Siksik ^f, P. Lebray ^g, M. Rudler ^g, D. Thabut ^g, T. Poynard ^g, B. Bouhemad ^h, D. Eyraud ⁱ, O. Gostian ⁱ, S. Fratea ⁱ, B. Barrou ^j
^f Department of Digestive and Hepato-Pancreato-Biliary Surgery, La Pitié-Salpêtrière Hospital, AP–HP, UPMC Univ Paris 06, France
^g Department of Hepato-gastro-enterology, La Pitié-Salpêtrière Hospital, AP–HP, UPMC Univ Paris 06, 47-80, boulevard de l’Hôpital, 75013 Paris, France
^h Department of Anesthesiology and Critical Care Medicine; University Hospital, Dijon, France
ⁱ Department of Anesthesiology and Critical Care Medicine, La Pitié-Salpêtrière Hospital, AP–HP, UPMC Univ Paris 06, France
^j Unit of Renal Transplantation, Department of Urology, La Pitié-Salpêtrière Hospital, AP–HP, UPMC Univ Paris 06, France

^a Department of Anesthesiology and Critical Care Medicine, Multidisciplinary Intensive Care Unit, AP–HP, La Pitié-Salpêtrière Hospital, université Paris 06, université Pierre-et-Marie-Curie, 75013 Paris, France^{^{1
www.reapitie-univparis6.aphp.fr/.}}
^b UMR-S 945, La Pitié-Salpêtrière Hospital, Institut national de la santé et de la recherche médicale, AP–HP, université Paris 06, université Pierre-et-Marie-Curie, 75013 Paris, France
^c Department of Digestive and Hepato-Pancreato-Biliary Surgery, AP–HP, La Pitié-Salpêtrière Hospital, université Paris 06, université Pierre-et-Marie-Curie, 75013 Paris, France
^d Inserm, U1082, plateform IBISA, université de Poitiers, faculté de médecine et de pharmacie, 86021 Poitiers, France
^e ER4 “Modélisation en recherche clinique”, université Paris 06, université Pierre-et-Marie-Curie et UF de biostatistique, La Pitié-Salpêtrière Hospital, 75013 Paris, France

^⁎Corresponding author. Réanimation polyvalente, département d’anesthésie-réanimation, 47-83, boulevard de l’hôpital, 75013 Paris, France.

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Summary

Introduction

During liver transplantation, graft ischemia-reperfusion injury leads to a systemic inflammatory response producing postoperative organ dysfunctions. The aim of this observational and prospective study was to compare the impact of Solution de conservation des organes et tissus (SCOT) 15 and University of Wisconsin (UW) preservation solutions on early cytokine release, postreperfusion syndrome and postoperative organ dysfunctions.

Methods

Thirty-seven liver transplantations were included: 21 in UW Group and 16 in SCOT 15 group. Five cytokines were measured in systemic blood after anesthetic induction, 30minutes after unclamping portal vein and on postoperative day 1.

Results

Following unclamping portal vein, cytokines were released in systemic circulation. Systemic cytokine concentrations were higher in UW than in SCOT 15 group: Interleukin-10, Interleukine-6. In SCOT 15 group, significant reduction of postreperfusion syndrome incidence and acute kidney injury were observed. Alanine and aspartate aminotransferase peak concentrations were higher in SCOT 15 group than in UW group. However, from postoperative day 1 to day 10, aminotransferase returned to normal values and did not differ between groups.

Conclusions

Compared to UW, SCOT 15 decreases systemic cytokine release resulting from graft ischemia-reperfusion injury and reduces incidence of postreperfusion syndrome and postoperative renal failure.

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Abbreviations : AUC, HES, IGL-1, PEG, SCOT 15, UW

Plan

Introduction

Materials and methods

Study protocol

Measurement of cytokines

Definition of organ failure

Investigational product

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Vol 41 - N° 5

P. 564-574 - octobre 2017 Retour au numéro

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Impact of graft preservation solutions for liver transplantation on early cytokine release and postoperative organ dysfunctions. A pilot study - 15/12/17

Summary

Introduction

Methods

Results

Conclusions

Plan

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