Functional and structural integrity of porcine pancreatic grafts subjected to a period of warm ischemia and cold preservation with histidine-tryptophan-ketoglutarate (custodiol) or University of Wisconsin solution

Abstract

Porcine pancreatic grafts are viable after 16-hr CI following 15-min WI in this experimental nonheartbeating donor model. HTK solution seems to provide reliable graft function in this setting and to be equivalent to UW.

Histidine-Tryptophan-Ketoglutarate (HTK) Is Associated with Reduced Graft Survival in Pancreas Transplantation

“…Furthermore, A closer examination of the allograft survival curves in Figure 2 suggested a dominant early effect of preservation solution; this was consistent with a recent single-center report (2). To differentiate between early and late effects in the national population, we developed a multivariate Reduced Pancreas Graft Survival with HTK these results are the short CIT (<12 h) in this (4) and prior case series (2,(5)(6)(7)(8)(9) (13)(14)(15)(16)(17). These gross findings also correlated with histological evidence of increased interstitial edema and cellular swelling (15)(16)(17).…”

“…To differentiate between early and late effects in the national population, we developed a multivariate Reduced Pancreas Graft Survival with HTK these results are the short CIT (<12 h) in this (4) and prior case series (2,(5)(6)(7)(8)(9) (13)(14)(15)(16)(17). These gross findings also correlated with histological evidence of increased interstitial edema and cellular swelling (15)(16)(17). At least one group noted clinical correlation with HTKpreserved human pancreas allografts, as they reported that all HTK-flushed pancreas allografts appeared more edematous as compared to UW-flushed pancreas allografts (7).…”

Preservation of the donor pancreas for whole pancreas and islet transplantation

“…Recently, a porcine model of DCD, using 15‐min warm ischemia followed by 16 h of cold ischemia has shown HTK to be as effective as UW for pancreas preservation. There was less biochemical evidence of pancreatitis within the grafts and similar values of intravenous glucose tolerance testing amongst autografted recipients (146).…”

Pancreas Procurement and Preservation for Islet Transplantation: Personal Considerations

“…This solution has a low viscosity, easy handling properties, and a relatively low cost. Some studies have demonstrated similar results between UW and HTK solutions for pancreas preservation, in not only experimental animal models [43, 50, 51] but also clinical pancreas transplantation [52–54]. We used HTK solution with ulinastatin (modified HTK solution (M-HTK)) in this study because MK solution includes ulinastatin.…”