Comparison of histidine-tryptophan-ketoglutarate solution (HTK) and University of Wisconsin solution (UW) in adult liver transplantation

Abstract

See Editorial on Page 196University of Wisconsin solution (UW) is the standard preservation solution in cadaveric liver, kidney, pancreas, and small bowel transplantation. The effectiveness of this solution has been demonstrated and has revolutionized the field of transplant surgery. Several competing preservation solutions have been developed, and studies comparing these solutions to UW are ongoing. Histidine-tryptophan-ketoglutarate preservation solution (HTK) was developed in the 1970s as a cardioplegia solution and has recently been used routinely by many centers in kidney, liver, and pancreas preservation.1-8 The composition of these solutions has been described in detail previously. UW was developed by Folkert O. Belzer and is based upon three philosophies: 1) osmotic concentration maintained by metabolically inert substrates, 2) additional administration of the colloid carrier hydroxyethylstarch (HES), and 3) addition of oxygen radical scavengers. UW provides organ tolerance to long cold Abbreviations: HTK, Histidine-tryptophan-ketoglutarate solution; UW, University of Wisconsin solution. Address reprint requests to Dr.

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

“…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.…”

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

“…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.…”

¿Influye el medio de preservación del injerto en los resultados y costos del trasplante hepático de donante fallecido? Comparación de dos soluciones de preservación

“…Importante es mencionar que inicialmente todos los hígados fueron perfundidos con UW (única solución disponible en el país); pese a lo anterior, la comparación entre ambas soluciones nos parece igualmente válida, tal como ha sido comunicada por otros autores 20,21 . La mayor cantidad de HTK utilizada respecto a UW, puede ser explicada por las recomendaciones iniciales del proveedor y eventualmente por la menor viscosidad de HTK.…”