Pancreas transplantation with histidine-tryptophan-ketoglutarate (HTK) solution and University of Wisconsin (UW) solution: is there a difference?

ABSTRACT

CONTEXT In clinical pancreas transplantation the choice of preservation solution may have an impact on graft pancreatitis. Experience with histidine-tryptophan-ketoglutarate (HTK) is still limited whereas University of Wisconsin (UW) solution is currently the preferred perfusate worldwide. OBJECTIVE: The aim of this study was to analyze our experience with HTK in pancreas transplantation. PARTICIPANTS: In a retrospective analysis, data from 95 primary simultaneous pancreas-kidney transplantations were reviewed. The use of HTK (n=48) and UW (n=47) solution was stratified into two groups. MAIN OUTCOME MEASURES: Patient/graft survival and early graft function were compared. RESULTS: No significant differences between 1, 3 and 12 month patient survival (HTK 97.9%, 97.9%, and 95.7% vs. UW 95.7%, 89.4%, and 89.4%, respectively), and pancreas graft survival (HTK 87.5%, 87.5%, and 85.4% vs. UW 87.0%, 82.6%, and 82.6%, respectively) were detected. Higher values for peak lipase were observed on day 1 in the HTK group (not reaching significance: P=0.131) whereas no differences were noted for amylase and C-reactive protein. CONCLUSIONS: HTK is clinically comparable to UW. Both solutions have been shown to be safe for pancreas preservation. Successful pancreas transplantation depends on many factors such as donor and recipient factors, but skilled organ procurement techniques, organ preservation, and transplant experience in this field is mandatory. The choice of organ preservation solution is only one point in this context.