P.151: A Comparative Analysis of IGL-1 Versus HTK Solution in Pancreas Transplantation

Abstract

Georges Lopez Institute(IGL-1) is a relatively new preservation solution used for static cold storage of abdominal organs. Although the use of IGL-1 in liver or kidney transplantation is more established, there are limited data regarding its use in pancreas transplantation(PT). The aim of this study was to analyze our experience with IGL-1 in PT. In a retrospective analysis, data from 186 PT performed from jan/2019 to June/2021, being 121 SPK and 65 solitary PT(S-PT) were reviewed. The use of HTK(n=104) and IGL-1(n=82) solution was stratified into two groups. The profile of donors and recipients, post-transplant(PO) pancreatic enzymes and outcomes were compared. There were no significant differences between HTK and IGL-1 groups regarding recipient race, age(34.4 x 35.7 years),gender, cerebrovascular cause of donor death(24% x 23.2%), pancreas(8.2 x 8.0h) and kidney(9.5 x 9.3h) cold ischemia time and distribution of SPK/S-PT(59.6%/40.4% x 71.9%/28.1%). Donor age(26.0 x 29.7 years,p=0.002) and use of duodenal drainage(0.96% x 47.6%,p<0.001) were significantly different between HTK and IGL-1 group, respectively. Peak Amylase(379 x 364 UI/ml) and Lipase(364 x 271UI/ml) and PO day 5 Amylase(159 x 148UI/ml) and Lipase(95 x 83UI/ml) were similar between groups. However, peak amylase from drain fluid was higher in HTK group(3869 x 2333 UI/ml, p=0.045). Mean hospital stay(7.8 x 8.0 days), time with abdominal drain(10.5 x 11.4 days) and kidney DGF(45.2% x 52.5%) for SPK were also similar between HTK and IGL-1 groups, respectively. There was a tendency of better 1-year patient survival (89% x 81.7%,p=0.167) and significant higher 1-year pancreas(82.9% x 68.3,p=0.022) and kidney(89.8% x 74.2%,p=0.026) graft survivals for the IGL-1 group. The IGL-1 group was also followed by lower rate of early reoperations (8.5% x 19.2%, p=0.04), technical failure(7.3% x 17.3%,p=0.047) and death related to technical issues(2.4% x 10.6%, p=0.031). IGL-1 seems to be superior to HTK solution for pancreas preservation and achieved better outcomes particularly regarding technical issues.