Experience with hystidine tryptophan ketoglutarate versus University Wisconsin preservation solutions in transplantation.
We present our experience with histidine tryptophan ketoglutarate (HTK) and University Wisconsin (UW) preservation solutions in liver transplantation and a review of the literature in pancreas and kidney transplantation comparing these solutions. A group of 134 liver transplantations in 123 recipients was analyzed retrospectively. Grafts procured in adults were perfused with HTK in 63 cases and with UW in 71 cases. We compared results according to preoperative, intraoperative, and postoperative parameters, as well as complications and survival. No differences regarding donor and recipient data, intraoperative fresh frozen plasma (FFP) substitution, length of intensive care unit (ICU) stay, and ischemic damage of the graft were found. The rate of complications was comparable in both groups. However, the bilirubin was higher in the UW group. The rate of biliary complications was higher in the UW group (n = 8) versus the HTK group (n = 5). HTK ischemic type biliary lesions (ITBL) were only present in the UW group. Patient and graft survival were statistically nonsignificant. The data confirm that HTK and UW, with exception of biliary complications, are considered comparable in clinical liver transplantation. The same conclusion can be taken from the literature analyzed concerning renal transplantation, and in smaller groups of pancreas transplants, similar results were published.
Department of Surgery, Hammersmith Hospital, London University Campus, London, UK. rcanelo@gmx.de
Ruben
R
Canelo
Nadey S
NS
Hakim
Burckhardt
B
Ringe
D000241:Adenosine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D001652:Bile Ducts / Q000473:pathology; D003251:Constriction, Pathologic; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D005978:Glutathione / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007328:Insulin / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008353:Mannitol / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011189:Potassium Chloride / Q000627:therapeutic use*; D011343:Procaine / Q000627:therapeutic use*; D011887:Raffinose / Q000627:therapeutic use*
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; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose