Comparison of histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution for organ preservation in human liver transplantation

Erhard, J; Länge, R.; Scherer, R.; Kox, Wolfgang J.; Bretschneider, H. J.; Gebhard, Martha Maria; Eigler, F. W.

doi:10.1007/bf00327084

Cited by 98 publications

(86 citation statements)

References 8 publications

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“…37 Several studies support this hypothesis by demonstrating equivalent graft survival, and similar, or even lower, biliary complications. [39][40][41][42][43] We performed a subgroup analysis to evaluate what effect preservation solution had on graft and patient survival for recipients of DCD or matched recipients of DBD donors. When DCD donors were preserved with HTK, recipient survival tended to be better when compared with recipients of DBD donors preserved with either HTK or UW.…”

Section: Discussionmentioning

confidence: 99%

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Vanatta

Dean

Hathaway³

et al. 2013

Exp Clin Transplant

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Objectives: Organ donation after cardiac death remains an available resource to meet the demand for transplant. However, concern persists that outcomes associated with donation after cardiac death liver allografts are not equivalent to those obtained with organ donation after brain death. Results: Patient and graft survival rates were similar in both groups at 1 and 3 years (P = .444 and P = .295). There was no statistically significant difference in primary nonfunction, vascular complications, or biliary complications. In particular, there was no statistically significant difference in ischemic-type diffuse intrahepatic strictures (P = .107). Conclusions: These findings provide further evidence that excellent patient and graft survival rates expected with liver transplants using organ donation after brain death donors can be achieved with organ donation after cardiac death donors without statistically higher rates of morbidity or mortality when a comprehensive approach that controls for careful donor and recipient matching, surgical technique, and preservation solution is used.

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Section: Discussionmentioning

confidence: 99%

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Vanatta

Dean

Hathaway³

et al. 2013

Exp Clin Transplant

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“…15 HTK is currently widely used as a preservation solution secondary to its lower cost and acceptable graft survival outcomes. 24 Smaller studies have also implicated that use of HTK may result in a lower rate of biliary complications than UW solution, 25,26 which is possibly related to lower viscosity. Our present study supports this contention in that HTK was independently protective against anastomotic biliary stricture.…”

Section: Discussionmentioning

confidence: 99%

Biliary complications following liver transplantation in the model for end-stage liver disease era: Effect of donor, recipient, and technical factors

et al. 2007

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Biliary complications remain a significant problem following liver transplantation in the Model for End-Stage Liver Disease (MELD) era. We hypothesized that donor, recipient, and technical variables may differentially affect anastomotic biliary complications in MELD era liver transplants. We reviewed 256 deceased donor liver transplants after the institution of MELD at our center and evaluated these variables' association with anastomotic biliary complications. The bile leak rate was 18%, and the stricture rate was 23%. Univariate analysis revealed that recipient age, MELD, donor age, and warm ischemia were risk factors for leak, whereas a Roux limb or stent was protective. A bile leak was a risk factor for anastomotic stricture, whereas use of histidine tryptophan ketoglutarate (HTK) versus University of Wisconsin (UW) solution was protective. Additionally, use of a transcystic tube/stent was also protective. Multivariate analysis showed that warm ischemia was the only independent risk factor for a leak, whereas development of a leak was the only independent risk factor for a stricture. HTK versus UW use and transcystic tube/stent use were the only independent protective factors against stricture. Use of an internal stent trended in the multivariate analysis toward being protective against leaks and strictures, but this was not quite statistically significant. This represents one of the first MELD era studies of deceased donor liver transplants evaluating factors affecting the incidence of anastomotic bile leaks and strictures. Donor, recipient, and technical factors appear to differentially affect the incidence of anastomotic biliary complications, with warm ischemia, use of HTK, and use of a stent emerging as the most important variables. Liver Transpl 14: 73-80, 2008.

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“…Liver biopsy was performed routinely between graft reperfusion and the end of surgery. Thirty-one liver biopsy specimens were excluded from analysis; 17 biopsy specimens because of poor quality, 9 biopsy specimens because they were related to hepatic artery thrombosis (HAT), and 7 biopsy specimens because histidine-tryptophan-ketoglutarate solution 8 was used for preservation instead of University of Wisconsin solution (2 patients also had HAT).…”

Section: Methodsmentioning

confidence: 99%

Postreperfusion biopsies are useful in predicting complications after liver transplantation

Busquets

Figueras

Serrano

et al. 2001

Liver Transplantation

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Biliary complications after orthotopic liver transplantation (OLT) may occur because of preservation injury (PI).In this study, we examine findings on routine reperfusion biopsy specimens in relation to the occurrence of biliary complications and graft outcome. From 1997 to 2000, a total of 193 OLTs were performed in our center. Postreperfusion biopsy specimens were analyzed and histological lesions were graded. For analysis, grafts were grouped into 2 categories: the presence or absence of PI (severe to moderate lesions versus mild or no lesions). Histological evidence of PI was present in 17% of the biopsy specimens. The incidence of grafts with PI and ischemia time longer than 12 hours was 38% compared with 14% in PI and short ischemia time (P ‫؍‬ .02). Biliary complications were also more frequent in the PI group (28% v 14%; P ‫؍‬ .03). Study of risk factors by means of logistic regression analysis confirmed that the PI group had a greater risk for biliary complications (relative risk, 2.8; 95% confidence interval, 1 to 7.4; P ‫؍‬ .03). Moreover, moderate macrovesicular steatosis was found in 6% of the grafts, resulting in a 40% graft loss rate. We found that an increased presence of neutrophilic infiltrates in the postreperfusion biopsy specimen, indicating PI, was related to an increased incidence of biliary complications. Moreover, moderate macrovesicular steatosis was associated with increased graft loss. Therefore, postreperfusion biopsies are useful in anticipating post-OLT complications. (Liver Transpl 2001; 7:432-435.)

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Comparison of histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution for organ preservation in human liver transplantation

Cited by 98 publications

References 8 publications

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Biliary complications following liver transplantation in the model for end-stage liver disease era: Effect of donor, recipient, and technical factors

Postreperfusion biopsies are useful in predicting complications after liver transplantation

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