Efficacy and safety of Celsior preservation fluid in liver transplantation: one-year follow up of a prospective, multicenter, non-randomized study

Authors

  • Karim Boudjema,

    1. Service de Chirurgie Hépatobiliaire et Digestive, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes
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  • Stéphane Grandadam,

    1. Service de Chirurgie Hépatobiliaire et Digestive, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes
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  • Philippe Compagnon,

    1. Service de Chirurgie Hépatobiliaire et Digestive, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes
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  • Ephrem Salamé,

    1. Département de Chirurgie Digestive et de Transplantation Hépatique, Hôpital de la Côte de Nacre, Centre Hospitalier Universitaire de Caen, Caen
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  • Philippe Wolf,

    1. Service de Chirurgie Digestive et Transplantation, Hôpital de la Haute Pierre, Centre Hospitalier Universitaire de Strasbourg, Strasbourg
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  • Christian Ducerf,

    1. Service de Chirurgie Digestive et Transplantation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon
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  • Patrice Le Treut,

    1. Service de Chirurgie Générale, Hôpital de la Conception, Assistance Publique –- Hôpitaux de Marseille, Marseille
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  • Olivier Soubrane,

    1. Département des Maladies et Cancers du Foie, Hôpital Cochin, Assistance Publique –- Hôpitaux de Paris, Université Paris Descartes, Paris
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  • Daniel Cherqui,

    1. Service de Chirurgie Digestive, Hôpital Henri Mondor, Assistance Publique –- Hôpitaux de Paris, Créteil
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  • Catherine Mouchel,

    1. Service de Pharmacologie Clinique, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1
    2. Centre d’Investigation Clinique CIC-P INSERM 0203, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes, France
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  • Alain Renault,

    1. Service de Pharmacologie Clinique, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1
    2. Centre d’Investigation Clinique CIC-P INSERM 0203, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes, France
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  • Eric Bellissant

    1. Service de Pharmacologie Clinique, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1
    2. Centre d’Investigation Clinique CIC-P INSERM 0203, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes & Université de Rennes 1, Rennes, France
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  • Conflict of interest: The authors have no conflicts of interest to declare.

Corresponding author: Karim Boudjema, MD, PhD, Service de Chirurgie Hépato-biliaire et Digestive CHU de Rennes, Hôpital de Pontchaillou, Rue Henri Le Guilloux, 35033 Rennes Cedex 09, France.
Tel.: +33 299 288 496; fax: +33 299 284 129;
e-mail: karim.boudjema@chu-rennes.fr

Abstract

Boudjema K, Grandadam S, Compagnon P, Salamé E, Wolf P, Ducerf C, Le Treut P, Soubrane O, Cherqui D, Mouchel C, Renault A, Bellissant E. Efficacy and safety of Celsior preservation fluid in liver transplantation: one-year follow up of a prospective, multicenter, non-randomized study.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01447.x.
© 2011 John Wiley & Sons A/S.

Abstract:  The purpose of this prospective, nine-center, non-randomized study was to assess the efficacy and safety of Celsior preservation fluid in liver transplantation using unselected donors. As data comparing allograft outcomes following liver transplantation using Celsior and University of Wisconsin (UW) preservation fluids are limited, we also compared our cohort with matched controls selected from the European Liver Transplant Registry (ELTR) who received total liver grafts preserved with UW solution during the same period. One hundred and forty patients who received livers preserved with Celsior were included. The primary endpoint, graft loss at one-yr post-transplantation, was observed in 24 patients (17.1%) which was not significantly different from the 20.0% pre-defined threshold rate (95% confidence interval [CI] 10.9, 23.4; p = 0.398). Predictive factors for graft loss on univariate analysis were moderate-to-severe steatosis on the donor graft (5/22 patients with graft loss vs. 8/107 patients without, p = 0.046) and duration of warm ischemia (1.4 ± 1.1 h in patients with graft loss vs. 0.9 ± 0.5 h in patients without, p = 0.034). Hepatic artery thrombosis and stenosis occurred in seven (5.0%) and six (4.3%) patients, respectively. The comparison of our patients to 420 ELTR controls showed that one-yr graft survival rates (Celsior: 82.9%, 95% CI 75.8, 88.2; UW: 78.6%, 95% CI 74.4, 82.2) and Kaplan–Meier one-yr graft survival distributions (p = 0.285) were similar.

Within the cold ischemia time achieved in our study, liver preservation with Celsior appeared efficient and safe. Comparison with ELTR patients suggested that liver allograft survival was similar using Celsior or UW solution for preservation of unselected donor grafts.

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