HTK preservative solution is associated with increased biliary complications among patients receiving DCD liver transplants: A single center experience

Murat T. Gulsen, Mohit Girotra, Guldane Cengiz-Seval, Jennifer Price, Vikesh K. Singh, Dorry L. Segev, Andrew M. Cameron, Ahmet Gurakar

Research output: Contribution to journalArticle

Abstract

This study compares biliary complication rates associated with use of two different preservative solutions, Histidine-Tryptophan-Ketoglutarate (HTK) and University of Wisconsin (UW), utilized in orthotopic liver transplantation (LT) with donations after cardiac death (DCDs). Between 1997-2010, we retrospectively studied 35 LTs performed utilizing DCD donors, preserved either with HTK (n=17) or UW(n=18). Biliary complications were defined by the presence of anastomotic strictures, non-anastomotic strictures, and/or biliary leak on endoscopic retrograde cholangiopancreatography. HTK and UW cohorts were similar in terms of demographics as well as pre- and post-operative biochemical profile. Donor age was significantly higher among HTK compared to UW recipients (41.5±11.9 vs. 26.2±8.8 years, p<0.001). The incidence of post-LT biliary complications was higher in the HTK group (76% vs. 39% in UW group, p=0.041). Hepatic arterial thrombosis (HAT) was observed among 3 HTK patients (17.7%) and 1 UW patient (5.6%), p=0.33. No patients underwent retransplantation in UW group, five recipients in HTK group underwent retransplantation (29%), p=0.019; 4 due to biliary complications and 1 due to HAT. PERSONONLY This single-center study reveals that the use of HTK preservative among DCD donors is associated with an increased risk of biliary complications. Multicenter retrospective studies are suggested to further verify this observation.

Original languageEnglish (US)
Pages (from-to)69-75
Number of pages7
JournalAnnals of Transplantation
Volume18
Issue number1
DOIs
StatePublished - May 8 2013

Keywords

  • Biliary complications
  • DCD
  • HTK
  • Liver transplantation
  • Preservative
  • UW

ASJC Scopus subject areas

  • Transplantation

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