title: Comparison of histidine-tryptophan-ketoglutarate and University of Wisconsin in living-donor liver transplantation.
abstract: For cadaveric transplantations, histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) solutions have been shown to engender similar outcomes. In September 2004, our institution changed from UW to HTK as the primary preservation solution for liver and kidney transplantations. We reviewed records of living-donor liver transplant recipients from September 2001 to December 2005. This study compared early postoperative outcomes of liver transplantation using the 2 solutions. Perfusion was performed first via the portal vein and then via the hepatic artery until the outflow became clear. Patients were compared based on the organ preservation solution. The analysis included patient demographics, early postoperative complication rates, mortality rates, number of acute rejection episodes, costs for preservation solutions, and results of 1-, 7-, 14-, and 30- day liver function tests. Patients in both groups were managed with similar operative techniques, immunosuppressive regimens, and donor liver criteria. Statistical analyses were performed with chi- square and Mann-Whitney U tests. Donor and patient demographics were similar. No statistically significant differences were observed between the groups with regard to posttransplantation liver biochemistry, complication rates, number of acute rejection episodes, and mortality rates. The mean infused volume of preservation solution was 1000 +/- 400 mL (range, 500-2000 mL) for all patients. These volumes corresponded to a cost savings of US 148 dollars/L when using HTK solution. In conclusion, UW and HTK were equally effective and safe for perfusion of living-donor liver grafts; however, the use of HTK solution provided significant cost savings.
authors.affiliation: Department of General Surgery, Baskent University, Ankara, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Moray
authors.forename: S
authors.initials: S
authors.lastname: Sevmis
authors.forename: F Y
authors.initials: FY
authors.lastname: Karakayali
authors.forename: S K
authors.initials: SK
authors.lastname: Gorur
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D005260:Female; D005947:Glucose; D005978:Glutathione; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use; D007328:Insulin; D008099:Liver; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008353:Mannitol; D019188:Organ Preservation Solutions; D011189:Potassium Chloride; D011343:Procaine; D011887:Raffinose; D012189:Retrospective Studies; D016559:Tacrolimus / Q000097:blood / Q000627:therapeutic use
chemical_list: C039984:Bretschneider cardioplegic solution; D007166:Immunosuppressive Agents; 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; D016559:Tacrolimus