title: Increased pancreatitis in allografts flushed with histidine-tryptophan-ketoglutarate solution: a cautionary tale.
abstract: We reviewed pancreas transplantation outcomes after Histidine-Tryptophan-Ketoglutarate (HTK) and University of Wisconsin (UW) preservation solution use between 2001 and 2007 at two transplant centers. While equivalence has been claimed for kidney and liver transplant outcomes after the use of HTK or UW preservation solution, consensus has not been reached on equivalence when flushing pancreata. Others have reported comparable patient and graft survival rates, but found an association between the use of HTK and an increase in the incidence of acute rejection and pancreatitis. In reviewing our experiences, we found in pancreata flushed with HTK a higher incidence of postoperative complications including graft pancreatitis, use of octreotide and a decreased rate of insulin-independence at hospital discharge. These findings prompted us to critically review our centers' experience to determine if there is a basis for suspecting a causal relationship.
authors.affiliation: Department of Surgery, Division of Transplantation, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: D
authors.initials: D
authors.lastname: Alonso
authors.forename: T B
authors.initials: TB
authors.lastname: Dunn
authors.forename: T
authors.initials: T
authors.lastname: Rigley
authors.forename: J Y
authors.initials: JY
authors.lastname: Skorupa
authors.forename: M E
authors.initials: ME
authors.lastname: Schriner
authors.forename: L E
authors.initials: LE
authors.lastname: Wrenshall
authors.forename: R B
authors.initials: RB
authors.lastname: Stevens
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D005947:Glucose / Q000009:adverse effects / Q000191:economics; D006085:Graft Survival; D006801:Humans; D008353:Mannitol / Q000009:adverse effects / Q000191:economics; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000009:adverse effects* / Q000191:economics; D016035:Pancreas Transplantation; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011189:Potassium Chloride / Q000009:adverse effects / Q000191:economics; D011343:Procaine / Q000009:adverse effects / Q000191:economics; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous; D019737:Transplants; D016896:Treatment Outcome
chemical_list: C039984:Bretschneider cardioplegic solution; D019188:Organ Preservation Solutions; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose