Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival in deceased donor livers, especially those donated after cardiac death

Z. A. Stewart, A. M. Cameron, A. L. Singer, R. A. Montgomery, D. L. Segev

Research output: Contribution to journalArticlepeer-review

Abstract

Single-center studies have reported that liver allograft survival is not affected by preservation in histidine-tryptophan-ketoglutarate (HTK) versus University of Wisconsin (UW) solution. We analyzed the UNOS database of liver transplants performed from July, 2004, through February, 2008, to determine if preservation with HTK (n = 4755) versus UW (n = 12 673) impacted graft survival. HTK preservation of allografts increased from 16.8% in 2004 to 26.9% in 2008; this was particularly striking among donor after cardiac death (DCD) allografts, rising from 20.7% in 2004 to 40.9% in 2008. After adjusting for donor, recipient and graft factors that affect graft survival, HTK preservation was associated with an increased risk of graft loss (HR 1.14, p = 0.002), especially with DCD allografts (HR 1.44, P = 0.025) and those with cold ischemia time over 8 h (HR 1.16, P = 0.009). Furthermore, HTK preservation was associated with a 1.2-fold higher odds of early (< 30 days) graft loss as compared to UW preservation (OR 1.20, p = 0.012), with a more pronounced effect on allografts with cold ischemia time over 8 h (OR 1.31, p = 0.007), DCD allografts (OR 1.63, p = 0.09) and donors over 70 years (OR 1.67, p = 0.081). These results suggest that the increasing use of HTK for abdominal organ preservation should be reexamined.

Original languageEnglish (US)
Pages (from-to)286-293
Number of pages8
JournalAmerican Journal of Transplantation
Volume9
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • HTK solution
  • Liver transplantation
  • Preservation solutions
  • Procurement and preservation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival in deceased donor livers, especially those donated after cardiac death'. Together they form a unique fingerprint.

Cite this