Physiologic and metabolic results of pancreatic cold storage with Histidine-Tryptophan-Ketoglutarate-HTK solution (Custodiol) in the porcine autotransplantation model.
Delayed graft function (DEGF) remains an obscure phenomenon in organ transplantation. For the optimal washing of the compounds of the different organ flush solutions, adequate temperature and equilibrium of electrolytes have to be provided. A total of 29 land-race pigs weighing 37.3-5.4 kg were included in this study. According to the model, the left hemipancreas was perfused with Histidine-Tryptophan-Ketoglutarate (HTK)-solution and autotransplanted after 24 h (G1, n = 13) and 48 h (G2, n = 4) of cold storage (CS). Results were compared with grafts perfused with UW-solution and autotransplanted after 24 h (G3, n = 8) and 48 h (G4, n = 4) CS respectively. Daily measurements of glycemia, glucosuria, amylase and lipase were carried out. HTK perfusion resulted in an increase in wet weight of the grafts after 24 h and 48 h CS (P = 0.031 vs UW). Postoperative glycemia levels in pancreases flushed with HTK-solution were higher after 48 h than after 24 h CS until the 6th postoperative day, when the glycemia returned to normal range (P = 0.02), suggesting a delayed endocrine graft function. The mean IVGTT values attained after full function were comparable in G1 and in G3 (-1.22 +/- 0.23 vs. -1.5 +/- 0.65). The rises in serum amylase and lipase levels were more pronounced after 48 h CS in both HTK and UW groups, (P = n.s.). Appearance of interstitial and intracellular edema after CS and reperfusion did not influence the function.


CONCLUSIONS
HTK-solution is suitable for 24 h pancreatic preservation in vivo; the perfusion requires at least 4 min for electrolyte equilibration. Long preservation time (48 h) resulted in a transitory DEGF.
Troisi
R
R
Department of General and Transplant Surgery, University Hospital Ghent, Belgium. roberto.troisi@rug.ac.be
Meester
D
D
Regaert
B
B
Jacobs
B
B
Van den Broucke
C
C
Cuvelier
C
C
de Hemptinne
B
B
Hesse
U J
UJ
D000818:Animals; D015925:Cryopreservation; D005947:Glucose; D008353:Mannitol; D019188:Organ Preservation Solutions; D010179:Pancreas; D016035:Pancreas Transplantation; D011189:Potassium Chloride; D011343:Procaine; D013552:Swine; D014182:Transplantation, Autologous
C039984:Bretschneider cardioplegic solution; D019188:Organ Preservation Solutions; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose