***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Translational studies in liver transplantation often require an endpoint of graft function or dysfunction beyond graft loss . Prior definitions of early allograft dysfunction ( EAD ) vary , and none have been vali date d in a large multicenter population in the Model for End-Stage Liver Disease ( MELD ) era . We examined an up date d definition of EAD to vali date previously used criteria , and correlated this definition with graft and patient outcome . We performed a cohort study of 300 deceased donor liver transplants at 3 U.S. programs . EAD was defined as the presence of one or more of the following previously defined postoperative laboratory analyses reflective of liver injury and function : bilirubin > or=10mg/dL on day 7 , international normalized ratio > or=1.6 on day 7 , and alanine or aspartate aminotransferases > 2000 IU/L within the first 7 days . To assess predictive validity , the EAD definition was tested for association with graft and patient survival . Risk factors for EAD were assessed using multivariable logistic regression . Overall incidence of EAD was 23.2 % . Most grafts met the definition with increased bilirubin at day 7 or high levels of aminotransferases . Of recipients meeting the EAD definition , 18.8 % died , as opposed to 1.8 % of recipients without EAD ( relative risk = 10.7 [ 95 % confidence interval : 3.6 , 31.9 ] P < 0.0001 ) . More recipients with EAD lost their grafts ( 26.1 % ) than recipients with no EAD ( 3.5 % ) ( relative risk = 7.4 [ 95 % confidence interval : 3.4 , 16.3 ] P < 0.0001 ) . Donor age and MELD score were significant EAD risk factors in a multivariate model . In summary a simple definition of EAD using objective posttransplant criteria identified a 23 % incidence , and was highly associated with graft loss and patient mortality , validating previously published criteria . This definition can be used as an endpoint in translational studies aim ing to identify mechanistic pathways leading to a subgroup of liver grafts with clinical expression of suboptimal function Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more HE SCARCITY OF donors and the increase in the number of transplant c and i date s have stimulated research to minimize the loss of donated organs . Preservation solutions are available to conserve the organs for a determinate period . In liver transplant ( LT ) Belzer and Brettschneider solutions give satisfactory results . However , graft malfunction remains a problem and other solutions are being examined . This r and omized comparative study aims to examine the hepatic function of grafts perfused with Celsior solution ( CS ) and Belzer solution ( BS ) following liver transplant in adults ALTHOUGH University of Wisconsin ( UW ) solution remains the most commonly used for all intrabdominal organs , Celsior solution , widely utilized in clinical setting for the preservation of intrathoracic organs , has been recently proposed as a cold-storage solution for abdominal organs . One of the reasons for focusing on abdominal preservation with Celsior is to proceed with one solution for the preservation of all organs . Experimental studies have shown excellent results in kidney , liver , and tissue preservation in alternative to the U W. Celsior , due to its peculiar physical properties ( osmotic pressure ) , is able to limit the edema that develops rapidly after cold ischemia and able to prevent free-radical mediated tissue injury by its biochemical characteristics . Its clinical use in these organs is now under investigation in different centers . The only report about Celsior solution for human liver preservation experiences in a small , uncontrolled series , and the study suggested that this solution is appropriate for clinical use in liver preservation . A prospect i ve , r and omized , multicenter open clinical trial was instituted to compare preservation properties of the two solutions in liver transplantation , and a detailed report of the completed study will be made at a later date . This preliminary report contains the data collected from a single center to prove the equivalence of both solutions with regard to initial functioning and short and long-term graft and patient survival University of Wisconsin ( UW ) solution has been the st and ard for preservation of liver transplantation grafts since 1989 . However , some studies demonstrated that histidine-tryptophan-ketoglutarate ( HTK ) solution is also effective . The purpose of this study was to compare the efficacy of both solutions in liver transplantation . From January 2003 to August 2004 the livers of deceased donors were r and omized into HTK and UW groups . The 102 studied patients included 65 ( 63.7 % ) in the UW group and 37 ( 36.3 % ) in the HTK group . Sex , race , hemodynamic state , use of adrenergic drugs , and presence of steatosis in the donor were similarly distributed in the two groups ( P > .05 ) . The mean age of the donors was 38.1 years ( SD + /-14.4 ) in the UW group and 44.6 years ( SD + /-14.2 ) in the HTK cohort ( P = .036 ) . Sex , race , age , etiology of the cirrhosis , retransplant , acute liver failure , portal thrombosis , and Child-Pugh and MELD scores in the recipients were similarly distributed in the two recipient sample s ( P > .05 ) . Among 89 patients who completed 4 months of follow-up , the HTK group included eight cases ( 25.8 % ) of biliary complications versus five cases ( 8.6 % ) in the UW group ( P = .033 ; OR = 2.0 95 % CI = 1.2 - 3.5 ) . The incidence of graft dysfunction was 2.8 % in the HTK group and 9.4 % in the UW group ( P = .15 ) . In conclusion , UW and HTK solutions were equally effective for the preservation of the hepatic graft . The routine use of HTK solution can reduce the costs of liver transplantation Background Celsior solution ( CS ) is a high-sodium , low-potassium , low-viscosity extracellular solution that has been used for liver graft preservation in recent years , although experience with it is still limited . We performed an open-label r and omized active-controlled trial comparing CS with the University of Wisconsin solution ( UW ) for liver transplantation ( LT ) , with a follow-up period of 5 years . Methods Adult transplant recipients ( n = 102 ) were prospect ively r and omized to receive either  CS ( n = 51 ) or  UW ( n = 51 ) . The two groups were comparable with respect to donor and recipient characteristics . The primary outcome measure was the incidence of postreperfusion syndrome ( PRS ) . Secondary outcome measures included primary nonfunction ( PNF ) or primary dysfunction ( PDF ) , liver retransplantation , and graft and patient survival . Other secondary outcome measures were days in the intensive care unit ( ICU ) and the rates of acute rejection , chronic rejection , infectious complications , postoperative reoperations , and vascular and biliary complications . Results In all , 14 posttransplant variables revealed no significant differences between the groups . There were no cases of PNF or PDF . The incidence of PRS was 5.9 % in the CS group and 21.6 % in the UW group ( P = 0.041 ) . After reperfusion , CS revealed greater control of serum potassium ( P = 0.015 ) , magnesium levels ( P = 0.005 ) , and plasma glucose ( P = 0.042 ) than UW . Respective patient survivals at 3 , 12 , and 60 months were 95.7 , 87.2 , and 82.0 % for the CS group and 95.7 , 83.3 , and 66.6 % for the UW group ( P = 0.123 ) . Conclusions While retaining the same degree of safety and effectiveness as UW for LT , CS may yield postliver graft reperfusion benefits , as shown in this study by a significant reduction in the incidence of PRS and greater metabolic control University of Wisconsin solution is currently recognized as the best solution for long-term organ preservation . It is recommended that UW solution be used as the in situ flush prior to organ explantation . The purpose of our study was to determine if hepatic allograft function was impaired by flushing the graft in situ with Euro-Collins and later flushing the graft ex vivo with UW solution , prior to cold storage . Fifty-six donors were r and omly assigned to either an EC ( n=24 ) or UW ( n=32 ) in situ flush . The livers flushed with EC in situ were later flushed with 1 L of UW on the back table and stored in UW solution . Livers flushed with UW in vivo were similarly flushed and stored in UW on the back table . Concerning the donor allograft , there was no statistical difference ( P<0.05 ) between groups in sex , race , blood type , arterial anatomy , age , prothrombin time ( PT ) , partial thromboplastin time ( PTT ) , total bilirubin ( TBR ) , direct bilirubin ( DBR ) , aspartate amino transferase ( AST ) , or alanine amino transferase ( ALT ) . In addition , the recipients were compared for differences in sex , race , blood type , preoperative status , number of rejections , recipient age , length of surgery , and ischemia time and patient survival . There was no significant difference between groups ( P < 0.05 ) . There was no significant difference in patient survival ( P = 0.238 ) . Values for TBR , AST , ALT , PT , PTT , and AP were collected immediately preoperatively and post-operatively and on postoperative days 1 , 3 , 7 , 14 , and 28 . There was no difference between groups in these values ( P < 0.05 ) . In our study there was no difference between the groups with respect to graft performance . This would justify the use of EC as an in situ flush during solid organ procurement and flushing with UW solution on the back table with an estimated savings of 400 to 1200 per procurement University of Wisconsin solution ( UWS ) is the gold st and ard for graft preservation . Celsior solution ( CS ) is a new solution not as yet widely used in liver grafts . The aim of this study was to compare the liver function of transplanted grafts stored in these 2 preservation solutions . The primary endpoints were the rates of primary nonfunction ( PNF ) and primary dysfunction ( PDF ) . We performed a prospect i ve and pseudor and omized study that included 196 patients ( representing 104 and 92 livers preserved in UWS and CS , respectively ) at La Fe University Hospital ( Valencia , Spain ) between March 2003 and May 2005 .  PNF and PDF rates , liver function laboratory parameters , postoperative bleeding , vascular and biliary complications , and patient and graft survival at 3 years were compared for the 2 groups . The 2 groups were similar in terms of donor variables , recipient variables , and surgical techniques . The PNF rates were 2.2 % and 1.9 % in the CS and UWS groups , respectively ( P = not significant ) , and the PDF rates were 15.2 % and 15.5 % in the CS and UWS groups , respectively ( P = not significant ) . There were no significant differences in the laboratory parameters for the 2 groups , except for alanine aminotransferase levels in month 3 , which were lower in the CS group ( P = 0.01 ) . No significant differences were observed in terms of complications . Three-year patient and graft survival rates were as follows for years 1 , 2 , and 3 : 83 % , 80 % , and 76 % ( patient ) and 80 % , 77 % , and 73 % ( graft ) for the UWS group and 83 % , 77 % , and 70 % ( patient ) and 81 % , 73 % , and 67 % ( graft ) for the CS group ( P = not significant ) . In conclusion , this study shows that CS is as effective as UWS in liver preservation Background . Viaspan ( University of Wisconsin [ UW ] ) solution is the gold st and ard for abdominal organ preservation . Celsior ( CEL ) is an extracellular-type , low-potassium , low-viscosity solution , initially used for heart and lung preservation . We have performed a prospect i ve multicenter study to compare the role of these cold-storage solutions on  kidney and liver recovery after transplantation . Patients and Methods . From March 15 , 2000 to December 31 , 2001 , 441 ( 172 CEL and 269 UW ) renal transplants ( RT ) and 175 ( 79 CEL and 96 UW ) liver transplants ( LT ) were included in the study . Results . Perfusate volume used was significantly lower in the UW group , being 4,732±796 mL versus 5,826±834 mL in the CEL group ( P < 0.001 ) . In LT , median total bilirubin serum levels were significantly higher at 5 and 7 posttransplant days in the UW group ( 90.6 and 92.3 μmol/L , respectively ) as compared with CEL ( 51.3 and 63.4 μmol/L , respectively ) . After LT , primary nonfunction ( PNF ) rates in the CEL and UW groups were 3.8 
    Output:
    
There was no good evidence of any difference in outcomes when comparing histidine-tryptophan-ketoglutarate with either of the University of Wisconsin or Celsior solution , although data were limited .
Data from included studies suggest that preservation of deceased donor livers with the University of Wisconsin or Celsior solution results in equivalent outcomes