Avaliação hepática após transplante de fígado : estudo comparativo utilizando solução de Belzer e Collins

Abstract

The hepatic transplant is the standard treatment for terminal hepatic illness. With the refinement of the surgical technique, improvement of the effectiveness of the immunosuppressive drugs, the better knowledge of the reperfusion injury and the use of more physiological solutions of preservation, had a considerable increase of the survival of hepatic graft. The Collins’ preservation solution used since 1969 , in renal transplant, is simplest and most economic preservation solution. The Belzer’s solution is used world wide and preserves hepatic graft for a longer period, although more expensive. The present study it compares 2 projects of hepatic perfusion using the Collins and Belzer’s solution. The difference between the two groups is that the Belzer’s solution perfused for the portal vein is substituted by the solution of Collins. At Walter Cantídio Hospital of the Federal University of the Ceará 49 patients submitted to hepatic transplant of deceased donors graft were evaluated. The hepatic function after the transplant was evaluated through parameters AST, ALT, INR and Bilirubin in first and the seventh postoperative day. The time of cold ischemia was less than 10 hours in all the patients. There was no difference between the two groups in the analyzed parameters, except in the INR of the group where Collins’ solution in the portal vein was perfused, which was greater in the 1º postoperative day. The two projects of hepatic preservation can be used with security, as the cold ischemia time is less than 10 hours, however, it had a reduction of the cost of the liver transplant in the group that used a lesser volume of the solution of Belzer.