Comparison of Preservation Solutions and Their Effect on the Prognosis of Liver Transplants in São Paulo: An Analysis in Patients with Primary Graft Dysfunction or Primary Non-Function of the Hepatic Graft

• Grant number: 24/19447-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2025
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: André Ibrahim David
• Grantee: Matheus Viana Ferreira
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Liver failure, divided into acute, subacute, and chronic forms, is the primary indication for liver transplantation. The acute form involves an abrupt and sudden injury to liver cells, presenting with high mortality. The subacute form can be lethal within weeks, while the chronic form is marked by a progressive loss of function. Recently, acute-on-chronic liver failure (ACLF) syndrome has been investigated as a severe complication in patients with chronic liver disease, leading to rapid clinical deterioration and a high mortality.Liver transplantation offers a viable option for critically ill patients. The MELD score helps establish transplant priorities, while advancements in surgical techniques, anesthesia, and immunosuppressive medications (such as cyclosporine and tacrolimus) have improved outcomes. In Brazil, the liver graft survival rate reaches 73% after one year; however, organ scarcity remains a significant challenge, highlighting the need to maximize graft application.During transplantation, proper graft preservation is crucial for the success of the procedure and can significantly impact postoperative outcomes, including the occurrence of primary graft dysfunction (PGD) or primary non-function (PNF). Various preservation solutions, such as UW, Celsior, IGL-1, and Custodiol, are used to maintain the organ's viability during transport and storage. Each solution has unique characteristics, and the choice typically depends on the transplant center's protocol. Investigating the differences in patient prognosis associated with the use of these solutions is essential for improving transplant outcomes.