A prospective randomized multicenter trial comparing histidine-tryptophane-ketoglutarate versus University of Wisconsin perfusion solution in clinical pancreas transplantation

Abstract

Summary We aimed to evaluate early pancreas transplant graft function after histidine–tryptophan–ketoglutarate (HTK) versus University of Wisconsin (UW) perfusion. Prospective randomized multicenter study including 68 pancreas transplantations stratified according to preservation fluid used (27 HTK vs. 41 UW). Primary endpoint was pancreas graft survival at 6 months. Serum α‐amylase, lipase, C‐peptide, HbA1C and exogenous insulin requirement were compared at several time points. Mean pancreas cold ischemia time was 10.8 ± 3.7 (HTK) vs. 11.8 ± 3.4 h (UW) (P = 0.247). Simultaneous pancreas–kidney transplantation was performed in 95.6% of the patients, pancreas transplantation alone in 2.9%, and pancreas after kidney transplantation in 1.5%. Six months graft survival was 85.2% (HTK) vs. 90.2% (UW) (P = 0.703). Serum amylase and lipase values did not differ between both the groups during the observation period. C‐peptide levels were elevated in both the groups without significant differences at each time point. Higher exogenous insulin requirement early after transplantation in the UW group had resolved at 3 months. Six month patient survival was 96.3% (HTK) vs. 100% (UW) (P = 0.397). With a mean cold ischemia time of 10 h in this study, HTK and UW solutions appear to be equally suitable for perfusion and organ preservation in clinical pancreas transplantation.

Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

“…The low scores observed in all experiment groups for inflammatory infiltrates are in line with previous observations made by our working group and might be attributed to the short reperfusion period of 2 h 20. We hypothesize that the minimal reduced cell viability and histology observed for naïve pancreata can be attributed to the damage from organ perfusion, procurement, and the staining process 34, 35, 36.…”

Histidine‐Tryptophan‐Ketoglutarate for Pancreas Allograft Preservation: The Indiana University Experience

“…A recent two-center case series (6) (11,19,20 The first published report of successful pancreas transplantation using HTK flush and preservation was from Indiana University in 2004 (12). Ten pancreas allografts preserved in HTK were compared to the prior 10 allografts stored in UW.…”

Pancreas transplantation in the treatment of diabetes mellitus type 1: modern aspects

“…Использование этого раствора для консер-вации несколько повышает вероятность развития отека и тромбоза поджелудочной железы в сравне-нии с раствором UW. Уменьшение времени тепло-вой ишемии при использовании раствора HTK до 12 часов и менее (в том числе за счет правил аллока-ции), снижение объема перфузии до 10 литров при мультиорганном изъятии позволяет достичь схожих с UW результатов выживаемости трансплантата поджелудочной железы [52].…”