Abstract
We previously reported a small-scale study on the efficacy of histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution on pancreas preservation for islet isolation. In this large-scale, retrospective analysis (n = 252), we extend our initial description of the impact of HTK on islet isolation outcomes and include pancreatic digestion efficacy, purification outcomes, and islet size distribution. Multivariable linear regression analysis, adjusted for donor age, sex, BMI, cold ischemia time, and enzyme, demonstrated similar results for the HTK group (n = 95) and the UW group (n = 157), including postpurification islet yields (HTK: 289,702 IEQ vs. UW: 283,036 IEQ; p = 0.76), percentage of digested pancreatic tissue (HTK: 66.9% vs. UW: 64.1%; p = 0.18), and islet loss from postdigestion to postpurification (HTK: 24,972 IEQ vs. UW: 39,551 IEQ; p = 0.38). Changes in islet size between the postdigestion and postpurification stages were comparable within each islet size category for HTK and UW (p = 0.14-0.99). Tissue volume distribution across purification fractions and islet purity in the top fractions were similar between the groups; however, the HTK group had significantly higher islet purity in the middle fractions (p = 0.003-0.008). Islet viability and stimulation indices were also similar between the HTK and the UW groups. In addition, we analyzed a small sample of patients transplanted either with HTK (n = 7) or UW (n = 8) preserved islets and found no significant differences in posttransplant HbA1c, β-score, and frequency of insulin independence. This study demonstrates that HTK and UW solutions offer comparable pancreas preservation for islet transplantation. More in vivo islet outcome data are needed for a complete analysis of the effects of HTK on islet transplantation.
Highlights
The quality of pancreas flush and preservation is one of the most important determining factors for the successful grafting of both whole pancreata and isolated islets
Since 1995, a number of studies have assessed the ability of HTK to preserve pancreata intended for islet isolation, with results similar to those obtained with other organ preservation solutions and paralleling those demonstrated for other abdominal organs [7,15,16,30]
A significant difference was observed for cold ischemia time (CIT), for which the HTK group had a longer ischemia time than the University of Wisconsin (UW) group (p = 0.02)
Summary
The quality of pancreas flush and preservation is one of the most important determining factors for the successful grafting of both whole pancreata and isolated islets. Since 1995, a number of studies have assessed the ability of HTK to preserve pancreata intended for islet isolation, with results similar to those obtained with other organ preservation solutions and paralleling those demonstrated for other abdominal organs [7,15,16,30]. These studies have been limited either by small sample size or incomplete analysis of isolation outcomes
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