Early pancreas transplant outcomes with histidine-tryptophan-ketoglutarate preservation: a multicenter study.
ABSTRACT Little is known about the use of histidine-tryptophan-ketoglutarate (HTK) preservation solution for pancreas preservation. We compared early pancreas graft outcomes at four pancreas transplant programs within the state of Michigan in 2002 and 2003 (University of Wisconsin [UW] era) with those in 2004 (HTK era). The primary endpoint was early graft loss. The UW group (n=41) and the HTK group (n=36) had similar outcomes with respect to: technical graft loss (9.8% vs. 8.3%, P=NS), 90-day graft function (90.2% vs. 86.1%, P=NS), and rate of pancreatic leak/abscess (12.2% vs. 11.1%, P=NS). There were also no significant differences in postoperative amylase and lipase levels between the two groups. The HTK group did have significantly more acute rejection within the first 180 days (25.0% vs. 9.8%, P<0.05). HTK is a suitable substitute for UW in the preservation of pancreas allografts.
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ABSTRACT: Donation after cardiac death (DCD) has the potential to significantly increase the number of organ donors nationwide by at least 10%, which is the current goal of the National Organ Donation and Transplantation Collaboratives. Several organ procurement organizations in the United States currently exceed this goal with nearly 20% of their organ donors being DCD donors. With the Joint Commission on Accreditation of Healthcare Organizations asking all hospitals in the United States to have a policy on DCD donation, the number of DCD donors nationwide is expected to increase. Likewise, the numbers of organs transplanted from DCD donors is expected to increase since transplantation results with kidneys, pancreata, livers, lungs, and, in two cases, heart transplantation, have been similar to results from brain-dead donors. Equally, if not more important, is the ability to offer the opportunity of organ donation as part of the continuum of care at the end of life for patients and families. The comfort and healing nature of being able to leave a legacy of life through organ donation is well known and should never be underestimated whether donation occurs in the DCD or brain-death setting.Transplantation Reviews 10/2007; 21(4):230-236. · 2.66 Impact Factor
Article: Preservación de órganos[Show abstract] [Hide abstract]
ABSTRACT: Maintaining organ viability from extraction to transplantation is crucial to ensure the function and survival of the graft. In recent years, maintaining organ viability has become more challenging because the shortage of donors has led to broader criteria for donor acceptability and consequently to organs with greater compromise.Organ damage occurs primarily as a result of ischemia-reperfusion injury, which is associated to additional damage from the preservation process. To minimize this damage, different techniques of organ preservation are used with the aim of optimizing organ function once perfusion is restored.Static cold storage is the most commonly used method of preservation because it is extremely simple, nearly universally available, and easy to transport. However, static cold storage may be unable to prevent the deterioration of the quality of organs from donors included under the broader criteria. In this article, we describe current preservation techniques; we place special emphasis on continuous machine perfusion.Medicina Intensiva 08/2009; 33(6):282-292. · 1.24 Impact Factor
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ABSTRACT: We investigated zooplankton distribution in September 2006/2007 at eight stations across Fram Strait in contrasting water masses ranging from cold Polar water to warm Atlantic water. Our main objectives were: (1) to describe the plankton community in the upper 200m during autumn, and (2) to investigate the importance of small-sized copepods and protozooplankton in an arctic ecosystem when the majority of the large Calanus species had entered diapause. We sampled both with a WP-2 net and Go-Flo bottle and show that small copepodsProgress In Oceanography 12/2011; · 3.99 Impact Factor