Comparison of histidine-tryptophan-ketoglutarate solution and university of wisconsin solution in intestinal and multivisceral transplantation

Richard S. Mangus, A. Joe Tector, Jonathan A. Fridell, Marwan Kazimi, Edward Hollinger, Rodrigo M. Vianna

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

BACKGROUND.: Previous studies have failed to demonstrate a clinical difference between histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions in clinical transplant outcomes for liver, pancreas, and kidney transplantation. This study compares HTK and UW in bowel transplantation with primary outcomes being graft and patient survival, early graft function, and episodes of rejection. METHODS.: Data were extracted using a retrospective chart and medical record review of all bowel transplants between 2003 and 2007, and included both pediatric and adult grafts. Transplanted organs included isolated small bowel, modified multivisceral (bowel, pancreas, and stomach) and multivisceral (bowel, pancreas, stomach, and liver). Immunosuppression included induction with a steroid taper and antithymocyte globulin and anti-CD20 monoclonal antibody (rituximab), followed by maintenance with prograf monotherapy. Bowel surveillance was performed with twice weekly zoom endoscopy and biopsy. RESULTS.: There were 54 patients transplanted with 57 grafts, 22 preserved in UW, and 37 in HTK. No differences were noted between the two solutions in initial graft function, appearance of bowel on initial endoscopy, and number of rejection episodes. There were no episodes of pancreatitis in the 44 multivisceral grafts which included a transplant pancreas (14 UW and 30 HTK). Kaplan-Meier survival analysis did not demonstrate a significant difference in graft or patient survival at 30- or 90-days posttransplant. CONCLUSIONS.: Intestinal grafts preserved in UW and HTK demonstrate no difference in graft and patient survival at 30- and 90-days posttransplant. There were no differences noted in initial function, endoscopic appearance, rejection episodes, or transplant pancreatitis.

Original languageEnglish (US)
Pages (from-to)298-302
Number of pages5
JournalTransplantation
Volume86
Issue number2
DOIs
StatePublished - Jul 27 2008

Fingerprint

Transplantation
Transplants
Histidine
Tryptophan
Pancreas
Graft Survival
Pancreatitis
Endoscopy
Stomach
Bretschneider cardioplegic solution
Pancreas Transplantation
Antilymphocyte Serum
Kaplan-Meier Estimate
Tacrolimus
Survival Analysis
Liver Transplantation
Kidney Transplantation
Immunosuppression
Medical Records
Steroids

Keywords

  • Histidine-tryptophan-ketoglutarate solution
  • Intestinal transplantation
  • Organ preservation solutions
  • Organ procurement
  • University of Wisconsin solution

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Comparison of histidine-tryptophan-ketoglutarate solution and university of wisconsin solution in intestinal and multivisceral transplantation. / Mangus, Richard S.; Tector, A. Joe; Fridell, Jonathan A.; Kazimi, Marwan; Hollinger, Edward; Vianna, Rodrigo M.

In: Transplantation, Vol. 86, No. 2, 27.07.2008, p. 298-302.

Research output: Contribution to journalArticle

Mangus, Richard S. ; Tector, A. Joe ; Fridell, Jonathan A. ; Kazimi, Marwan ; Hollinger, Edward ; Vianna, Rodrigo M. / Comparison of histidine-tryptophan-ketoglutarate solution and university of wisconsin solution in intestinal and multivisceral transplantation. In: Transplantation. 2008 ; Vol. 86, No. 2. pp. 298-302.
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abstract = "BACKGROUND.: Previous studies have failed to demonstrate a clinical difference between histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions in clinical transplant outcomes for liver, pancreas, and kidney transplantation. This study compares HTK and UW in bowel transplantation with primary outcomes being graft and patient survival, early graft function, and episodes of rejection. METHODS.: Data were extracted using a retrospective chart and medical record review of all bowel transplants between 2003 and 2007, and included both pediatric and adult grafts. Transplanted organs included isolated small bowel, modified multivisceral (bowel, pancreas, and stomach) and multivisceral (bowel, pancreas, stomach, and liver). Immunosuppression included induction with a steroid taper and antithymocyte globulin and anti-CD20 monoclonal antibody (rituximab), followed by maintenance with prograf monotherapy. Bowel surveillance was performed with twice weekly zoom endoscopy and biopsy. RESULTS.: There were 54 patients transplanted with 57 grafts, 22 preserved in UW, and 37 in HTK. No differences were noted between the two solutions in initial graft function, appearance of bowel on initial endoscopy, and number of rejection episodes. There were no episodes of pancreatitis in the 44 multivisceral grafts which included a transplant pancreas (14 UW and 30 HTK). Kaplan-Meier survival analysis did not demonstrate a significant difference in graft or patient survival at 30- or 90-days posttransplant. CONCLUSIONS.: Intestinal grafts preserved in UW and HTK demonstrate no difference in graft and patient survival at 30- and 90-days posttransplant. There were no differences noted in initial function, endoscopic appearance, rejection episodes, or transplant pancreatitis.",
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AU - Hollinger, Edward

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AB - BACKGROUND.: Previous studies have failed to demonstrate a clinical difference between histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions in clinical transplant outcomes for liver, pancreas, and kidney transplantation. This study compares HTK and UW in bowel transplantation with primary outcomes being graft and patient survival, early graft function, and episodes of rejection. METHODS.: Data were extracted using a retrospective chart and medical record review of all bowel transplants between 2003 and 2007, and included both pediatric and adult grafts. Transplanted organs included isolated small bowel, modified multivisceral (bowel, pancreas, and stomach) and multivisceral (bowel, pancreas, stomach, and liver). Immunosuppression included induction with a steroid taper and antithymocyte globulin and anti-CD20 monoclonal antibody (rituximab), followed by maintenance with prograf monotherapy. Bowel surveillance was performed with twice weekly zoom endoscopy and biopsy. RESULTS.: There were 54 patients transplanted with 57 grafts, 22 preserved in UW, and 37 in HTK. No differences were noted between the two solutions in initial graft function, appearance of bowel on initial endoscopy, and number of rejection episodes. There were no episodes of pancreatitis in the 44 multivisceral grafts which included a transplant pancreas (14 UW and 30 HTK). Kaplan-Meier survival analysis did not demonstrate a significant difference in graft or patient survival at 30- or 90-days posttransplant. CONCLUSIONS.: Intestinal grafts preserved in UW and HTK demonstrate no difference in graft and patient survival at 30- and 90-days posttransplant. There were no differences noted in initial function, endoscopic appearance, rejection episodes, or transplant pancreatitis.

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