Potdar Santosh, Malek Sayeed, Eghtesad Bijan, Shapiro Ron, Basu Amit, Patel Kusum, Broznick Brian, Fung John
Division of Transplantation Surgery, University of Pittsburgh and the Thomas E. Starzl Transplantation Institute, Pittsburgh, PA 15213-3236, USA.
Clin Transplant. 2004 Dec;18(6):661-5. doi: 10.1111/j.1399-0012.2004.00262.x.
The colloid-based University of Wisconsin (UW) preservation solution has been used extensively in clinical pancreas transplantation. Experimental studies support the use of the crystalloid-based histidine-tryptophan-ketoglutarate (HTK) preservation solution for this purpose.
We report our initial experience with HTK for pancreas allograft preservation and compare this to a contemporary experience with UW solution in conventional multiorgan deceased donors (<50 yr).
Retrospectively collected information on 33 pancreas transplants between September 2001 and October 2002 were analyzed for early graft function and complications up to 30 d after procurement and storage in either HTK or UW solutions. During multi-organ recovery, either UW solution (4-5 L) or HTK solution (8-10 L) was used for aortic perfusion and subsequent back-table flush and storage. Exocrine drainage of 31 pancreas allografts was enteric, while the bladder was used for drainage in two cases. Patient outcomes were analyzed according to the preservation solution used. Sixteen pancreata were used in combination with a kidney allograft (SPK), seven were used in patients after prior kidney transplantation (PAK), while 10 were used in patients who were not in renal failure (PTA).
The UW group consisted of 17 patients (10 SPK, three PAK, four PTA) with a mean donor age of 29.5 +/- 10.7, and a mean cold ischemia time of 15.1 +/- 2.1 h. The mean post-transplant pancreas and kidney function on days 1 and 10 were amylase (315 and 99 IU/L), lipase (1727 and 346 IU/L), glucose (121 and 100 mg/dL) and creatinine (5.01 and 1.77 mg/dL). Patient and graft survival was 100% at 1-month post transplant. In the HTK group there were 16 patients (six SPK, four PAK, six PTA) with a mean donor age 21.9 +/- 5.7 and a mean cold ischemia time 14.0 +/- 1.3 h. The mean post-transplant pancreas and kidney function on days 1 and 10 were amylase (588 and 126 IU/L), lipase (4711 and 441 IU/L), glucose (97 and 109 mg/dL) and creatinine (5.28 and 2.42 mg/dL). Patient survival was 100% while graft survival was 94% at 1-month post-transplant.
Early graft function and complications are comparable with HTK and UW solutions for pancreas allograft preservation.
基于胶体的威斯康星大学（UW）保存液已广泛应用于临床胰腺移植。实验研究支持为此目的使用基于晶体液的组氨酸 - 色氨酸 - 酮戊二酸（HTK）保存液。
我们报告使用HTK保存胰腺同种异体移植物的初步经验，并将其与当代使用UW溶液保存传统多器官脑死亡供体（<50岁）的经验进行比较。
回顾性收集2001年9月至2002年10月期间33例胰腺移植的信息，分析在使用HTK或UW溶液进行获取和保存后30天内的早期移植物功能和并发症。在多器官获取过程中，使用UW溶液（4 - 5升）或HTK溶液（8 - 10升）进行主动脉灌注以及随后的后台冲洗和保存。31例胰腺同种异体移植物的外分泌引流采用肠道引流，2例采用膀胱引流。根据所用的保存液分析患者的预后。16例胰腺与肾同种异体移植物联合使用（SPK），7例用于先前已进行肾移植的患者（PAK），10例用于未发生肾衰竭的患者（PTA）。
UW组有17例患者（10例SPK，3例PAK，4例PTA），供体平均年龄为29.5±10.7岁，平均冷缺血时间为15.1±2.1小时。移植后第1天和第10天胰腺和肾脏的平均功能指标为淀粉酶（315和99 IU/L）、脂肪酶（1727和346 IU/L）、葡萄糖（121和100 mg/dL）和肌酐（5.01和1.77 mg/dL）。移植后1个月患者和移植物存活率均为100%。HTK组有16例患者（6例SPK，4例PAK，6例PTA），供体平均年龄21.9±5.7岁，平均冷缺血时间14.0±1.3小时。移植后第1天和第10天胰腺和肾脏的平均功能指标为淀粉酶（588和126 IU/L）、脂肪酶（4711和441 IU/L）、葡萄糖（97和109 mg/dL）和肌酐（5.28和2.42 mg/dL）。移植后1个月患者存活率为100%，移植物存活率为94%。
对于胰腺同种异体移植物的保存，HTK溶液和UW溶液在早期移植物功能和并发症方面相当。
