Histidine-Tryptophan-Ketoglutarate (HTK) Is Associated with Reduced Graft Survival in Pancreas Transplantation

Stewart, Zoe A.; Cameron, Andrew M.; Singer, Andrew L.; Dagher, Nabil N.; Montgomery, Robert A.; Segev, Dorry L.

doi:10.1111/j.1600-6143.2008.02449.x

Cited by 91 publications

(48 citation statements)

References 18 publications

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“…21 Stewart and associates, in 2009, used the United Network for Organ Sharing (UNOS) database to show that HTK solution was associated with a higher rate of graft loss, especially within 30 days, compared with UW solution. 22 However, the vast majority of studies show equivalency between the 2 solutions. Interestingly, any differences seen may be due to confounding factors such as longer flush volumes recommended for HTK solution.…”

Section: Surgical Factorsmentioning

confidence: 99%

Prevention and Management of Graft Thrombosis in Pancreatic Transplant

Patel¹,

Hakim²

2012

Exp Clin Transplant

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Pancreatic transplant effectively cures type 1 diabetes mellitus and maintains consistent longterm euglycemia. However, technical failure, and in particular graft thrombosis, accounts for the vast majority of transplants lost in the early postoperative period. The pancreas' inherently low microvascular flow state makes it vulnerable to vascular complications, as does the hypercoagulable blood of diabetic patients. Ultimately, the phenomenon is most definitely multifactorial. Prevention, as opposed to treatment, is key and should focus on reducing these multiple risk factors. This will involve tactical donor selection, optimal surgical technique and some form of anticoagulation. Close monitoring and early intervention will be crucial when treating thrombosis once preventative methods have failed. This may be achieved by further anticoagulation, graft salvage, or pancreatectomy with retransplant. This article will explore the multiple factors contributing to graft thrombus formation and the ways in which they may be addressed to firstly prevent, or more likely, reduce thrombosis. Secondly, we will consider the management strategies which can be implemented once thrombosis has occurred.

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Section: Surgical Factorsmentioning

confidence: 99%

Prevention and Management of Graft Thrombosis in Pancreatic Transplant

Patel¹,

Hakim²

2012

Exp Clin Transplant

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“…Despite several trials, no consistent evidence of benefit has been shown, although some studies found a higher incidence of graft pancreatitis, a decreased rate of insulin independence at hospital discharge, and a higher rate of graft loss in HTK-stored pancreases (Stewart et al 2009). The potential benefits of oxygen carriage using the two-layer technique for islet transplantation (Kawamura et al 1992) did not to translate from the small animal models to clinical evidence (Kin et al 2008).…”

Section: B-cell Transplantation-the Process Organ Donationmentioning

confidence: 99%

Pancreas Transplantation: Solid Organ and Islet

Mittal

Johnson

Friend

2014

Cold Spring Harbor Perspectives in Medicine

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“…For abdominal organ transplantation, however, Histidine-Tryptophan Ketoglutarate (HTK) solution is increasingly being used [65][66][67][68][69][70][71][72][73]. The lower viscosity, reduced potassium, and lower cost are cited as the advantages of this solution.…”

Section: Pancreas Preservationmentioning

confidence: 99%

Expanding the Pancreas Donor Pool

Fridell

Stratta

2014

Curr Transpl Rep

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Currently underutilized and in somewhat short supply, the pancreas allograft is a relatively scarce resource. Despite factors such as increased demand, positive changes in organ donation rates, and the liberalization of 'organ-acceptable' criteria, there has been a decline in the number of deceased donor pancreas transplants performed in the US. Concomitantly, there has been an increase in similar transplants performed in other countries. While it is understandable that there are a multiplicity of factors to be considered in the evaluation of the potential pancreas allograft donor in an attempt to minimize graft loss and morbidity, it is a simple truth that as a result there are unused transplantable organs. This paper will deal with the multifaceted problem of pancreas underutilization and will discuss strategies that could lead to the expansion of the pancreas donor pool.

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Histidine-Tryptophan-Ketoglutarate (HTK) Is Associated with Reduced Graft Survival in Pancreas Transplantation

Cited by 91 publications

References 18 publications

Prevention and Management of Graft Thrombosis in Pancreatic Transplant

Prevention and Management of Graft Thrombosis in Pancreatic Transplant

Pancreas Transplantation: Solid Organ and Islet

Expanding the Pancreas Donor Pool

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