Primary nonfunction: Is there a contribution from the back table bath?

Erin M. Kennedy, R. Patrick Wood, Byers W. Shaw

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

A persistent problem in orthotopic liver transplantation (OLT) is primary nonfunction (PNF) of the hepatic allograft. In most instances the cause of the failure is unknown. In an attempt to minimize these graft failure, modifications in the procurement and operative procedure have been investigated. One change in the procedure at the University of Nebraska Medical Center has been the monitoring of the temperature of the fluid in the back table bath during preparation of the donor liver. Our initial procedure involved creating an ice slurry of lactated Ringer’s solution and ice slush in which the donor liver was then prepared. The temperature of this ice slurry was retrospectively found to be from —3°C to —1°C (group I). In this group there was a higher-than-expected incidence of PNF. To investigate whether the temperature of the back table bath influenced the incidence of PNF, beginning with transplant No. 42 the preparation of the back table bath was modified. The bath was created by adding a small amount of PlasmaLyte slush to 2 L of PlasmaLyte (group II). The temperature of the bath was maintained at 2—4°C. Data were collected on 100 consecutive liver transplants. All transplants were performed using standard techniques, the operation for the two groups differing only as described above. Transaminase levels were followed as an index of the allograft function and were expected to begin to normalize within 2-3 days after transplantation. While both groups display this trend, transaminase levels in group II were significantly lower postopera- tively than group I levels (jP<0.05). Preoperative values were similar. There were 7 PNFs in group I; 0 in group II (P<0.005). We feel that the change in the back table procedure has positively influenced the function of the hepatic allografts, and we conclude that transplant centers need to monitor the temperature at which all allo- grafts are stored and prepared, and be cognizant that this may influence the postoperative function of the transplanted liver.

Original languageEnglish (US)
Pages (from-to)739-743
Number of pages5
JournalTransplantation
Volume49
Issue number4
StatePublished - Apr 1990

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Baths
Transplants
Liver
Ice
Temperature
Allografts
Transaminases
Incidence
Operative Surgical Procedures
Liver Transplantation
Transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Kennedy, E. M., Patrick Wood, R., & Shaw, B. W. (1990). Primary nonfunction: Is there a contribution from the back table bath? Transplantation, 49(4), 739-743.

Primary nonfunction : Is there a contribution from the back table bath? / Kennedy, Erin M.; Patrick Wood, R.; Shaw, Byers W.

In: Transplantation, Vol. 49, No. 4, 04.1990, p. 739-743.

Research output: Contribution to journalArticle

Kennedy, EM, Patrick Wood, R & Shaw, BW 1990, 'Primary nonfunction: Is there a contribution from the back table bath?', Transplantation, vol. 49, no. 4, pp. 739-743.
Kennedy EM, Patrick Wood R, Shaw BW. Primary nonfunction: Is there a contribution from the back table bath? Transplantation. 1990 Apr;49(4):739-743.
Kennedy, Erin M. ; Patrick Wood, R. ; Shaw, Byers W. / Primary nonfunction : Is there a contribution from the back table bath?. In: Transplantation. 1990 ; Vol. 49, No. 4. pp. 739-743.
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