title: Functional and structural integrity of porcine pancreatic grafts subjected to a period of warm ischemia and cold preservation with histidine-tryptophan-ketoglutarate (custodiol) or University of Wisconsin solution.
abstract: BACKGROUND
  University of Wisconsin (UW) solution (Viaspan) is currently used to preserve organs from nonheartbeating donors. Histidine-tryptophan-ketoglutarate (HTK) solution (Custodiol) is of proven efficacy in experimental pancreas preservation, but its efficacy in combined warm ischemia (WI) and cold ischemia (CI) is unknown. The viability of HTK-preserved porcine pancreatic grafts was assessed after various periods of WI and compared with grafts flushed and preserved with UW solution.
  
  
  METHODS
  A total of 14 pigs were used: G1 (n=4, UW) and G2 (n=4, HTK) with 15-min WI and 16-hr cold storage; G3 (n=3, UW) and G4 (n=3, HTK) with 30-min WI and 16-hr cold storage.
  
  
  RESULTS
  All animals in G1 and G2 were normoglycemic, whereas only 66% of pancreases were functioning in G3 and G4. HTK perfusion was associated with increased wet weight. Transient hyperinsulinemia was noted in all the groups on postoperative day 1 (mean range: 8.9-12.4 microU/L). Postoperative serum amylase and lipase were more pronounced in G3 and G4. However, HTK-stored grafts exhibited less evidence of biochemical pancreatitis as compared with UW-stored grafts on the first postoperative day in the group with 15-min WI. Mean K values of intravenous glucose tolerance tests on postoperative day 14 were similar in both groups. Vascular congestion was uniformly observed and was considered a typical feature of WI.
  
  
  CONCLUSIONS
  Porcine pancreatic grafts are viable after 16-hr CI following 15-min WI in this experimental nonheartbeating donor model. HTK solution seems to provide reliable graft function in this setting and to be equivalent to UW.
authors.affiliation: Deparment of General, Hepato-Biliary and Transplantation Surgery, Ghent University Hospital, Gent, Belgium. roberto.troisi@rug.ac.be
authors.forename: Roberto
authors.initials: R
authors.lastname: Troisi
authors.forename: Daniel
authors.initials: D
authors.lastname: Meester
authors.forename: Carolien
authors.initials: C
authors.lastname: Van Den Broecke
authors.forename: Claude A
authors.initials: CA
authors.lastname: Cuvelier
authors.forename: Tom
authors.initials: T
authors.lastname: Fiers
authors.forename: Bernard
authors.initials: B
authors.lastname: de Hemptinne
authors.forename: Uwe J
authors.initials: UJ
authors.lastname: Hesse
mesh_terms: D000241:Adenosine / Q000494:pharmacology*; D000493:Allopurinol / Q000494:pharmacology*; D000681:Amylases / Q000097:blood; D000818:Animals; D003080:Cold Temperature; D004487:Edema / Q000097:blood / Q000473:pathology; D005978:Glutathione / Q000494:pharmacology*; D006085:Graft Survival / Q000187:drug effects*; D006358:Hot Temperature; D006946:Hyperinsulinism / Q000097:blood / Q000473:pathology; D007003:Hypoglycemia / Q000097:blood / Q000473:pathology; D007328:Insulin / Q000494:pharmacology*; D008049:Lipase / Q000097:blood; D023421:Models, Animal; D009926:Organ Preservation; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D010179:Pancreas / Q000473:pathology / Q000502:physiology; D016035:Pancreas Transplantation; D011887:Raffinose / Q000494:pharmacology*; D015427:Reperfusion Injury / Q000097:blood / Q000473:pathology*; D013552:Swine
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D008049:Lipase; D000681:Amylases; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose