Applicability of histidine-tryptophan-ketoglutarate solution in right lobe adult-to-adult live donor liver transplantation.
In a consecutive series of 60 right lobe adult-to-adult live donor liver transplantations (ALDLTs), safety and efficacy of the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) solution were evaluated. The first 30 liver grafts were perfused with UW solution and the subsequent 30 by HTK solution. Donor and recipient characteristics of both groups were comparable. All liver graft implantations were performed with cross-clamping of the inferior vena cava (IVC) and without veno-venous bypass. Main outcome measures were posttransplantation liver biochemistry, prothrombin time, and recipient morbidity, as well as graft and recipient survival. There were no significant differences of the outcome measures between the 2 groups. The low potassium content of the HTK solution nonetheless offered logistic advantages. In 25 of the 30 recipients of the HTK group, portal vein anastomosis was performed with a clamp on the donor portal vein while the clamps on the IVC were already released. This shortened the period during which the IVC was being cross-clamped. HTK solution was as safe and effective as a cold storage solution as UW solution in ALDLT. Its low potassium content has advantage of earlier restoration of patency of the IVC and thus hemodynamic stability. The cost of using HTK solution was also lower.
Chan
See Ching
SC
Centre for the Study of Liver Disease and Department of Surgery, University of Hong Kong, Pokfulam, Hong Kong, China.
Liu
Chi Leung
CL
Lo
Chung Mau
CM
Fan
Sheung Tat
ST
D000241:Adenosine / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D000493:Allopurinol / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000494:pharmacology*; D005978:Glutathione / Q000494:pharmacology*; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D008099:Liver / Q000187:drug effects*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008353:Mannitol / Q000494:pharmacology*; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D011189:Potassium Chloride / Q000494:pharmacology*; D011343:Procaine / Q000494:pharmacology*; D011887:Raffinose / Q000494:pharmacology*; D016896:Treatment Outcome
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