Early Pancreas Transplant Outcomes with Histidine-Tryptophan-Ketoglutarate Preservation: A Multicenter Study

Wayne State University, Detroit, Michigan, United States
Transplantation (Impact Factor: 3.83). 07/2006; 82(1):136-9. DOI: 10.1097/
Source: PubMed


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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    • "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). "
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    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.
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