Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in extended criteria liver donors

Richard Mangus, Jonathon A. Fridell, Rodrigo M. Vianna, Martin A. Milgrom, Paul Chestovich, Ray K. Chihara, A. Joseph Tector

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Liver, pancreas, and kidney allografts preserved in histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) solutions have similar clinical outcomes. This study compares HTK and UW in a large number of standard criteria donor (SCD) and extended criteria donor (ECD) livers at a single center over 5 years. All adult, cadaveric liver and liver-kidney transplants performed between July 1, 2001 and June 30, 2006 were reviewed (n = 698). There were 435 livers (62%) categorized as ECD for severe physiologic stress and 70 (10%) because of old age. Recipient outcomes included perioperative death or graft loss and overall survival. Liver enzymes were analyzed for the first month post-transplant. Biliary complications were assessed through chart review. Overall, 371 donor livers were preserved in HTK (53%), and 327 were preserved in UW (47%). There were no statistically significant differences in any of the primary outcome measures comparing HTK and UW. The HTK group overall had a higher day 1 median aspartate aminotransferase and alanine aminotransferase, but the two groups were similar in function thereafter. HTK was superior to UW in protection against biliary complications. Kaplan-Meier graft survival curves failed to demonstrate a significant difference in SCD or ECD livers. In conclusion, HTK and UW are not clinically distinguishable in this large sample of liver transplants, although HTK may be protective against biliary complications when compared to UW. These findings persisted for both SCD and ECD livers. Given the lower cost per donor for HTK, this preservation solution may be preferable for general use.

Original languageEnglish
Pages (from-to)365-373
Number of pages9
JournalLiver Transplantation
Volume14
Issue number3
DOIs
StatePublished - Mar 2008

Fingerprint

Histidine
Tryptophan
Liver
Transplants
Bretschneider cardioplegic solution
Kidney
Kaplan-Meier Estimate
Graft Survival
Aspartate Aminotransferases
Alanine Transaminase
Allografts
Pancreas
Outcome Assessment (Health Care)
Costs and Cost Analysis
Enzymes

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in extended criteria liver donors. / Mangus, Richard; Fridell, Jonathon A.; Vianna, Rodrigo M.; Milgrom, Martin A.; Chestovich, Paul; Chihara, Ray K.; Tector, A. Joseph.

In: Liver Transplantation, Vol. 14, No. 3, 03.2008, p. 365-373.

Research output: Contribution to journalArticle

Mangus, Richard ; Fridell, Jonathon A. ; Vianna, Rodrigo M. ; Milgrom, Martin A. ; Chestovich, Paul ; Chihara, Ray K. ; Tector, A. Joseph. / Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in extended criteria liver donors. In: Liver Transplantation. 2008 ; Vol. 14, No. 3. pp. 365-373.
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