Liver graft preservation methods during cold ischemia phase and normothermic machine perfusion

Table 1 Graft preservation solutions[31,32,58,59]

	UW	HTK	CE	IGL-1	SCOT
Potassium	High	Low	Low	High	Low
HES	Yes	No	No	No	No
PEG	No	No	No	PEG-35	PEG-20
Impermeant substances	Raffinose, lactobionate	No	Lactobionate	Raffinose, lactobionate	No
3-yr graft survival	75%	69% (P < 0.0001)	73%	75%	N/A
Special features	High viscosity, prevention of edema, ATP precursor and anti-oxidant components	No oncotic agents, potent buffer system, lower viscosity and potentially better penetration to the liver microcirculation, reported risk for reduced graft survival	No oncotic agents, lower viscosity and potentially better penetration to the liver microcirculation	Reported to be advantageous for suboptimal livers	Reported to reduce transplant cholestasis, to be involved in “immune-camouflage” process[31,58,59]

UW: University of Wisconsin solution; HTK: Histidine-tryptophane-ketoglutarate solution; CE: Celsior solution; IGL-1: Institute Georges Lopez solution; SCOT: Tissue and Organ Conservation Solution; HES: Hydroxyethyl-starch; PEG: Polyethylene-glycol; ATP: Adenosine triphosphate.

Table 2 Results of normothermic machine perfusion and static cold storage[92,104,123-126]

	Normothermic machine perfusion	Static cold storage
Max medium AST	417-1252 U/L (range 84-15009 U/L)	839-1474 U/L (range 153-8786 U/L)
Median INR	1.05-1.1 (range 0.88-1.6)	1.03-1.1 (range 0.90-2.2)
Median bilirubin	25-79 μmol/L (range 8-344 μmol/L)	30-48 μmol/L (range 9-340 μmol/L)
Median alkaline phosphatase	139-245 U/L (range 40-626 U/L)	147-243 U/L (range 58-743 U/L)
Early allograft dysfunction	ranged from 10% to 56%	ranged from 23% to 30%
Median ICU stay	3-16 d (range 1-65 d)	3-4 d (range 0-41 d)
Median hospital stay	12-45 d (range 6-114 d)	13-25 d (range 7-89 d)
Major complications	10%-22%	22%-37%
Graft survival	80%-100%	97.5%-100%
30 d mortality	2.5%-11%	0-2.5%

AST: Aspartate Aminotransferase; INR: International normalized ratio; ICU: Intensive care unit.