BENEFICIAL-EFFECTS OF EUROCOLLINS AS AORTIC FLUSH FOR THE PROCUREMENTOF HUMAN LIVERS

A review of 550 consecutively transplanted liver grafts stored in Univ ersity of Wisconsin solution (UW) was performed during a 4-year period to ascertain whether graft function was impaired by flushing the aort a with Eurocollins (EC) rather than UW during the harvesting. The outc ome of 255 liver grafts flushed with UW in both the aorta and portal v ein (group UW/UW) was compared with 295 liver grafts flushed with EC t hrough the aorta and UW through the portal vein (group EC/UW). Liver g rafts in both groups were flushed with 1 L of UW during the back table procedure and subsequently stored in UW at 4 degrees C before transpo rt. Donor and recipient characteristics, cold and warm ischemia times, and methods of transplantation were similar in both groups, except th at the recipient prothrombin time (PT) before liver transplantation (L T) was lower in the UW/UW group. There was no significant difference b etween the groups with peak transaminases aspartate aminotransferase ( AST) and alanine aminotransferase, maximum value of serum bilirubin wi thin 10 days following LT, incidence of primary nonfunction, need for retransplantation, and patient and graft survival at 1 month. Results were improved, however, in the EC/UW group in regard to PT after LT, o perative bleeding and proportion of grafts with histologic lesions at the reperfusion biopsy (P<0.001). These better results in the EC/UW gr oup were confirmed when grafts transplanted in urgent situations were excluded from analysis and by multivariate analysis assessing the effe cts of pretransplant PT and AST values of the recipients combined with the method of liver cooling with each of the aforementioned criteria. In conclusion, the method of using EC for the aortic flush during liv er procurement reduces the amount of UW solution by 50% with improved graft function. This method seems justified in that it is less expensi ve while affording improved graft function.