Histidine-tryptophan-ketoglutarate solution for organ preservation in human liver transplantation-a prospective multi-centre observation study.
Based on experimental work and clinical small studies, histidine-tryptophan-ketoglutarate (HTK) solution was found to be suitable not only for heart and kidney preservation but also for liver preservation. We decided, therefore, to use this preservation solution for clinical liver preservation in a prospective multi-centre trial. Enrolment to the study was from 1996 to 1999 in four European centres, and the results of 214 patients with HTK-preserved organs were analysed. Analysis showed a primary dysfunction (PDF) rate of 8.8%, with a primary non-function (PNF) rate of 2.3% and initial poor function (IPF) in 6.5%. Patient survival rate at 1 year was 83% and 1-year graft survival rate was 80%. In a univariate and a multivariate analysis PDF, early surgical complications and tendentiously severe infections (septicaemia, pneumonia, cholangitis) were identified as independent risk factors for graft and patient survival. Preservation with HTK can be regarded as an established alternative to preservation with University of Wisconsin (UW) solution when preservation times are short. Definitive assessment of the efficacy of preservation solutions requires further prospective randomised clinical trials that compare HTK and UW.
Pokorny
Herwig
H
Department of Transplant Surgery, University Hospital of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria, h.pokorny@akh-wien.ac.at
Rasoul-Rockenschaub
Susanne
S
Langer
Felix
F
Windhager
Thomas
T
Rosenstingl
Andreas
A
Lange
Reinhard
R
Königsrainer
Alfred
A
Ringe
Burckhardt
B
Mühlbacher
Ferdinand
F
Steininger
Rudolf
R
D004359:Drug Therapy, Combination; D005060:Europe; D005260:Female; D005947:Glucose; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology*; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011189:Potassium Chloride; D011343:Procaine; D012189:Retrospective Studies; D016019:Survival Analysis
C039984:Bretschneider cardioplegic solution; D007166:Immunosuppressive Agents; D019188:Organ Preservation Solutions; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose