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.
"Histidine ranges from 1,090 to 8,986 ppm in hyacinth bean seeds (Duke, 2008). Clinical trial results concluded that a histidine, tryptophan, and ketoglutarate formulation was suitable for the preservation of pancreas allografts (Englesbe et al., 2006). The alkaloid spermidine from hyacinth bean seeds (Bisby et al., 1994) has clinically been proven for use as a biomarker in skin cancer chemoprevention trials (Einspahr et al., 2006). "
[Show abstract][Hide abstract] ABSTRACT: The hyacinth bean, Lablab purpureus, is used throughout Asia and Africa for human food and medicine with potential to be a source of nutraceuticals and pharmaceuticals. Hyacinth bean accessions were grown in Griffin, Georgia, from 2002 to 2004 and characterized for agronomic traits including branching, foliage, plant size, days to 50% maturity, and seed reproduction. The plants regenerated a range reaching more than 4,000 seeds. Assessment of variation was determined using principal component analysis. This paper also discusses evidence from literature reviews regarding clinical trials supporting possible uses of various hyacinth bean phytochemicals as nutraceuticals and pharmaceuticals. Hyacinth bean seeds and pods could be used as famine food worldwide where humans suffer from malnourishment and disease. The purposes of this study are to characterize regenerating hyacinth bean genetic resources for branching, foliage, plant size, days to 50% maturity, seed production, and flower traits, as well as to discuss evidence from clinical trials supporting potential uses of various hyacinth bean containing phytochemicals as medicinal food, nutraceuticals, and pharmaceuticals.
Journal of Dietary Supplements 09/2009; 6(3):263-79. DOI:10.1080/19390210903070830
[Show abstract][Hide abstract] ABSTRACT: Purpose of review: Donor issues have a direct impact on the pancreas transplant surgical procedure and play a critical role in the success of the procedure. The purpose of this review is to examine several key donor issues that are likely to have a significant impact on outcomes after pancreas transplant. This review will focus on recent publications dealing specifically with issues related to the pancreas donor.
Recent findings: Overall pancreas donors remain underutilized, in the US and in Europe. Only about half of potential pancreas grafts are utilized at present. Concern over the quality of the organ, and the potential risk for surgical complications with extended criteria donor grafts is a major concern. Pancreas grafts from donation after cardiac death donors, for example, provide acceptable results in the long term, but may be associated with a higher incidence of early surgical problems. Risk factors for poor outcome can be identified with the donor that can help in better defining selection criteria, and may help to properly allocate pancreas grafts between whole organ versus islet cell transplantation.
Summary: Proper donor selection and defining donor risk factors plays a critical role in pancreas graft allocation and ultimately the success of the operative procedure.
Current Opinion in Organ Transplantation 01/2007; 12(1):73-76. DOI:10.1097/MOT.0b013e328012dd88 · 2.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
The aim of this study was to analyze our experience with HTK in pancreas transplantation.
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.
Patient/graft survival and early graft function were compared.
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.
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.
JOP: Journal of the pancreas 02/2007; 8(3):304-11.
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