Histidine‐Tryptophan‐Ketoglutarate for Pancreas Allograft Preservation: The Indiana University Experience

Abstract

Histidine‐tryptophan‐ketoglutarate solution (HTK) has been scrutinized for use in pancreas transplantation. A recent case series and a United Network for Organ Sharing data base review have suggested an increased incidence of allograft pancreatitis and graft loss with HTK compared to the University of Wisconsin solution (UW). Conversely, a recent randomized, controlled study failed to show any significant difference between HTK and UW for pancreas allograft preservation. This study was a retrospective review of all pancreas transplants performed at Indiana University between 2003 and 2009 comparing preservation with HTK or UW. Data included recipient and donor demographics, 7‐day, 90‐day and 1‐year graft survival, peak 30‐day serum amylase and lipase, HbA1c and C‐peptide levels. Of the 308 pancreas transplants, 84% used HTK and 16% UW. There were more SPK compared to pancreas after kidney and pancreas transplant alone in the HTK group. Donor and recipient demographics were similar. There was no significant difference in 7‐day, 90‐day or 1‐year graft survival, 30‐day peak serum amylase and lipase, HbA1c or C‐peptide. No clinically significant difference between HTK and UW for pancreas allograft preservation was identified. Specifically, in the context of low‐to‐moderate flush volume and short cold ischemia time (≤10 h), no increased incidence of allograft pancreatitis or graft loss was observed.