***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: The effectiveness of  liver preservation solutions remains in evidence . Cold ischemia time , steatosis , exp and ed criterion donors , operational cost , and survival represent important roles in its success . In a prospect i ve cohort study between August 2009 and April 2014 , 178 patients were allocated into an Institut Georges Lopez - 1 ( IGL-1 ) solution group ( 63.5 % ) or histidine-tryptophan-ketoglutarate ( HTK ) group  ( 36.5 % ) . There were no differences among recipient 's characteristics including age , skin color , gender , Model for End-stage Liver Disease score , acute rejection , cholestasis , and reperfusion syndrome incidences . Also , donors , age average , skin color , donor risk index , time in intensive care unit , hemodynamic variables , infections , and steatosis incidences were similar . The average cold ischemia time was 494 minutes in the IGL-1 group and 489 minutes in the HTK group ( P = .77 ) . Alanine aminotransferase and aspartate aminotransferase serum levels on the first postoperative day were 707 and 1185 mg/dL , respectively , with IGL-1 and 1298 and 2291 mg/dL , respectively , with HTK ( P = .016 ) and similar at day 15 ( P > .88 ) . The incidence of delayed graft function was 4.5 % with IGL-1 and 4.6 % with HTK ( P = .90 ) . The incidence primary nonfunction was 2.7 % with IGL-1 and 3.1 % with HTK ( P = .71 ) . The incidence of perioperative death was 11.5 % with IGL-1 and 13.8 % with HTK ( P = .94 ) . The survival in 30 months was 86 % in IGL-1 group and 82 % in HTK group ( P = .66 ) . Both preservation solutions are efficient to liver transplantations with deceased donors . Major prospect i ve trials are necessary to evaluate each preservation solution 's particularities . The preservation solution availability in each transplantation center must guide its use at the present moment 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 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 BACKGROUND To test the effectiveness of a simpler surgical technique for cadaveric liver procurement for liver transplantation , a prospect i ve r and omized study was carried out between August 1994 and December 1995 , to compare aortic perfusion only ( APO ) for flush-preservation of the liver with the conventional combined aortic and portal perfusion ( APP ) technique . METHODS Forty multiple organ donors were enrolled with 20 in each arm of the trial . Donor parameters ( age , bodyweight , liver function tests ) , surgeons performing the operations , the involvement of other procurement teams and the total ischaemic times were similar in the two groups . The liver recipients had a wide range of native liver pathology but were of similar age , sex and bodyweight in the two groups . RESULTS The mean procurement operation times for the APO and APP groups were 126.7+/-38.6 and 137.8+/-55.9 min , respectively ( P = ns ) . The perfusion took longer to complete in the APO group ( 10.2+/-1.7 vs 7.2+/-1.4 min ( APP ) , P < 0.001 ) . The liver temperature fell to its lowest level ( 12.5+/-3.4 degrees C ( APO ) vs 11+/-3 degrees C ( APP ) , P = ns ) in a similar time ( 11.9+/-3.8 min ( APO ) vs 9.3+/-3.4 mins ( APP ) , P = ns ) . There was no graft primary non-function or graft arterial injury in either group . There was no significant difference between the APO and APP initial graft outcomes . The 3-month patient survival rate was identical in the two groups ( 95 % ) ; 81 % of renal grafts from the APO donors functioned well from the time of transplantation as did 76 % of those from APP donors . CONCLUSIONS It is concluded that the APO procurement technique produces equivalent results to those achieved with the APP method . The simplicity of the APO technique makes it the preferred technique 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 ( 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 Primary dysfunction ( PDF ) still occurs after orthotopic liver transplantation ( OLT ) .  Celsior solution ( CS ) might offer some advantages over the conventional University of Wisconsin ( UW ) solution for organ preservation , but to date , this has not been prospect ively evaluated in the context of OLT . In this prospect i ve , r and omized , multicenter , pilot study , 215 potential liver donors were enrolled and r and omized . In 42 cases , the livers were unsuitable for transplantation ; therefore , 173 r and omized livers ultimately were implanted after perfusion and cold preservation with CS ( n = 83 ) or UW solution ( n = 90 ) . In accord with the indications of the CS manufacturing company , total CS infusion volume was 90 mL/kg , greater than that of UW solution ( 60 mL/kg ) . The main aim of the study is to compare the prevalence of PDF between the two groups . Donor and recipient variables were similar in the two groups . Episodes of PDF were numerically lower in the CS ( 2.4 % ) than UW group ( 7.8 % ) , but the difference was not statistically significant . There was a trend toward a lesser need for early re-OLT ( < 30 days ) in the CS group ( P = .0507 ) , but again , no statistically significant difference emerged . Overall and time-differentiated postoperative deaths also were similar . One-year actuarial patient ( UW , 89 % v CS , 87 % ) and graft ( UW , 83 % v CS , 85 % ) survival rates were similar . In conclusion , CS was similar to UW solution as a preservation solution in the clinical setting of OLT at the infusion volumes described , although some theoretical advantages of CS composition suggest that CS might prove a valid alternative to UW preservation solution in multiorgan harvesting , including the liver . A study on a larger patient basis is needed BACKGROUND Institut Georges Lopez-1 
    Output:
    
In conclusion , there is no significant evidence that aortic-only perfusion of the DBD liver compromises transplantation outcomes , and it may be favored because of its simplicity .
However , there is currently insufficient evidence to advocate for the use of any particular perfusion/preservation fluid over the others .