Safety and efficacy of living donor liver preservation with HTK solution.
Publication/Presentation Date
1-1-2005
Abstract
BACKGROUND: In living donor liver transplantation (LDLTx) organ procurement is usually well controlled, and allows to assess liver preservation and graft function under standardized conditions. Because publications on histidine-tryptophan-ketoglutarate (HTK) solution are limited, we prospectively studied its safety and efficacy in a consecutive series of LDLTx.
METHODS: Twenty-four patients received 22 right, 1 left, and 1 left lateral lobe graft. Liver preservation was done by gravity perfusion with HTK through portal vein, and hepatic artery, and flushing of bile ducts. Total ischemia time was 191 +/- 68 minutes.
RESULTS: There was no primary nonfunction, and all partial liver grafts showed good recovery: peak aspartate aminotransferase 577 U/L, total bilirubin 15.15 mg/dL, and partial thromboplastin time 49.37 seconds. One graft was lost from parenchymal fracture secondary to portal hyperperfusion after 6 days, and the patient was salvaged with retransplantation. Thirty-day mortality, including sudden cardiac death, pancreatitis, and hepatic artery rupture, was not related to graft dysfunction. Eight of 24 recipients developed early biliary leakage. There was no late ischemic type biliary lesion.
CONCLUSION: These results confirm that HTK solution is safe and effective when used in LDLTx. Potential advantages of HTK in comparison to other preservation solutions are low potassium concentration, low viscosity, no particles, in situ perfusion, no need to flush before reperfusion, improved biliary protection, better recovery of microcirculatory changes, ready to use, and lower costs. Because the risk-benefit ratio is of particular importance in LDLTx the use of HTK solution should be encouraged.
Volume
37
Issue
1
First Page
316
Last Page
319
ISSN
0041-1345
Published In/Presented At
Ringe, B., Braun, F., Moritz, M., Zeldin, G., Soriano, H., & Meyers, W. (2005). Safety and efficacy of living donor liver preservation with HTK solution. Transplantation proceedings, 37(1), 316–319. https://doi.org/10.1016/j.transproceed.2004.12.009
Disciplines
Medicine and Health Sciences
PubMedID
15808629
Department(s)
Department of Surgery
Document Type
Article