Open AccessHistidine‐tryptophan‐ketoglutarate solution for organ preservation in human liver transplantation—a prospective multi‐centre observation study
Author(s) -
Pokorny Herwig,
RasoulRockenschaub Susanne,
Langer Felix,
Windhager Thomas,
Rosenstingl Andreas,
Lange Reinhard,
Königsrainer Alfred,
Ringe Burckhardt,
Mühlbacher Ferdinand,
Steininger Rudolf
Publication year - 2004
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2004.tb00439.x
Subject(s) - medicine , viaspan , prospective cohort study , univariate analysis , surgery , liver transplantation , transplantation , clinical trial , pneumonia , liver function , multivariate analysis
Based on experimental work and clinical small studies, histidine‐tryptophan‐ketoglutarate (HTK) solution was found to be suitable not only for heart and kidney preservation but also for liver preservation. We decided, therefore, to use this preservation solution for clinical liver preservation in a prospective multi‐centre trial. Enrolment to the study was from 1996 to 1999 in four European centres, and the results of 214 patients with HTK‐preserved organs were analysed. Analysis showed a primary dysfunction (PDF) rate of 8.8%, with a primary non‐function (PNF) rate of 2.3% and initial poor function (IPF) in 6.5%. Patient survival rate at 1 year was 83% and 1‐year graft survival rate was 80%. In a univariate and a multivariate analysis PDF, early surgical complications and tendentiously severe infections (septicaemia, pneumonia, cholangitis) were identified as independent risk factors for graft and patient survival. Preservation with HTK can be regarded as an established alternative to preservation with University of Wisconsin (UW) solution when preservation times are short. Definitive assessment of the efficacy of preservation solutions requires further prospective randomised clinical trials that compare HTK and UW.