Histidine-tryptophan-ketoglutarate versus University of Wisconsin solution in living donor liver transplantation: results of a prospective study.
The grafts obtained from a living donor hepatectomy are perfused on the back table with either University of Wisconsin solution (UW) or histidine-tryptophan-ketoglutarate solution (HTK). The efficacy and safety of these solutions have been studied in cadaveric liver transplantation, however, there is no study comparing the two solutions in adult-to-adult living donor liver transplantation. In this study, UW and HTK were used in the perfusion of right living donor grafts. The grafts were perfused with a predetermined sequence and volume of one of the solutions. Liver biochemistries, complications, and graft and patient survival were analyzed. From January 2001 to September 2002, 30 grafts were alternately perfused with either UW (UW group) or HTK (HTK group). The perfusion was performed first via the artery and then via the portal vein with a predetermined volume. At a mean follow-up of 13 +/- 7 months, no significant statistical difference between groups UW and HTK in posttransplantation liver biochemistries, complications, or patient and graft survival (84% and 80%, respectively) was observed. In conclusion, UW and HTK are equally effective and safe in the perfusion of the living donor liver grafts. HTK has a slight practical advantage over UW because it does not need to be flushed away before reperfusion of the graft and is less expensive.
Testa
Giuliano
G
Department of General and Transplantation Surgery, University Hospital Essen, Germany.
Malagó
Massimo
M
Nadalin
Silvio
S
Treptow
Boris
B
Paul
Andreas
A
Frilling
Andrea
A
Broelsch
Christoph E
CE
D000241:Adenosine; D000410:Alanine Transaminase / Q000097:blood; D000493:Allopurinol; D005260:Female; D005947:Glucose; D005978:Glutathione; D006801:Humans; D007328:Insulin; D008099:Liver; D019520:Living Donors; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011189:Potassium Chloride; D011343:Procaine; D011446:Prospective Studies; D011887:Raffinose
C039984:Bretschneider cardioplegic solution; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D000410:Alanine Transaminase; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose