Histidine-tryptophan-ketoglutarate for pancreas allograft preservation: the Indiana University experience.
Histidine-tryptophan-ketoglutarate solution (HTK) has been scrutinized for use in pancreas transplantation. A recent case series and a United Network for Organ Sharing data base review have suggested an increased incidence of allograft pancreatitis and graft loss with HTK compared to the University of Wisconsin solution (UW). Conversely, a recent randomized, controlled study failed to show any significant difference between HTK and UW for pancreas allograft preservation. This study was a retrospective review of all pancreas transplants performed at Indiana University between 2003 and 2009 comparing preservation with HTK or UW. Data included recipient and donor demographics, 7-day, 90-day and 1-year graft survival, peak 30-day serum amylase and lipase, HbA1c and C-peptide levels. Of the 308 pancreas transplants, 84% used HTK and 16% UW. There were more SPK compared to pancreas after kidney and pancreas transplant alone in the HTK group. Donor and recipient demographics were similar. There was no significant difference in 7-day, 90-day or 1-year graft survival, 30-day peak serum amylase and lipase, HbA1c or C-peptide. No clinically significant difference between HTK and UW for pancreas allograft preservation was identified. Specifically, in the context of low-to-moderate flush volume and short cold ischemia time (<or=10 h), no increased incidence of allograft pancreatitis or graft loss was observed.
Fridell
J A
JA
The Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. jfridell@iupui.edu
Mangus
R S
RS
Powelson
J A
JA
D000328:Adult; D000681:Amylases / Q000097:blood; D002096:C-Peptide; D005260:Female; D005947:Glucose; D006085:Graft Survival; D006639:Histidine / Q000737:chemistry; D006801:Humans; D007196:Indiana; D007328:Insulin; D008049:Lipase; D008297:Male; D008353:Mannitol; D010179:Pancreas; D016035:Pancreas Transplantation / Q000401:mortality*; D011189:Potassium Chloride; D011343:Procaine; D014019:Tissue Donors; D014364:Tryptophan / Q000737:chemistry; D014922:Wisconsin
C039984:Bretschneider cardioplegic solution; D002096:C-Peptide; D007328:Insulin; D008353:Mannitol; D006639:Histidine; D011343:Procaine; D011189:Potassium Chloride; D014364:Tryptophan; D008049:Lipase; D000681:Amylases; D005947:Glucose