Moray G, Sevmis S, Karakayali F Y, Gorur S K, Haberal M
Department of General Surgery, Baskent University, Ankara, Turkey.
Transplant Proc. 2006 Dec;38(10):3572-5. doi: 10.1016/j.transproceed.2006.10.174.
For cadaveric transplantations, histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) solutions have been shown to engender similar outcomes. In September 2004, our institution changed from UW to HTK as the primary preservation solution for liver and kidney transplantations. We reviewed records of living-donor liver transplant recipients from September 2001 to December 2005. This study compared early postoperative outcomes of liver transplantation using the 2 solutions. Perfusion was performed first via the portal vein and then via the hepatic artery until the outflow became clear. Patients were compared based on the organ preservation solution. The analysis included patient demographics, early postoperative complication rates, mortality rates, number of acute rejection episodes, costs for preservation solutions, and results of 1-, 7-, 14-, and 30- day liver function tests. Patients in both groups were managed with similar operative techniques, immunosuppressive regimens, and donor liver criteria. Statistical analyses were performed with chi- square and Mann-Whitney U tests. Donor and patient demographics were similar. No statistically significant differences were observed between the groups with regard to posttransplantation liver biochemistry, complication rates, number of acute rejection episodes, and mortality rates. The mean infused volume of preservation solution was 1000 +/- 400 mL (range, 500-2000 mL) for all patients. These volumes corresponded to a cost savings of US 148 dollars/L when using HTK solution. In conclusion, UW and HTK were equally effective and safe for perfusion of living-donor liver grafts; however, the use of HTK solution provided significant cost savings.
对于尸体移植，已证明组氨酸 - 色氨酸 - 酮戊二酸（HTK）溶液和威斯康星大学（UW）溶液可产生相似的结果。2004年9月，我们的机构将肝脏和肾脏移植的主要保存溶液从UW溶液改为HTK溶液。我们回顾了2001年9月至2005年12月活体供肝移植受者的记录。本研究比较了使用这两种溶液进行肝移植的术后早期结果。首先通过门静脉进行灌注，然后通过肝动脉进行灌注，直到流出液变清。根据器官保存溶液对患者进行比较。分析包括患者人口统计学、术后早期并发症发生率、死亡率、急性排斥反应发作次数、保存溶液成本以及1天、7天、14天和30天肝功能测试结果。两组患者均采用相似的手术技术、免疫抑制方案和供肝标准进行管理。使用卡方检验和曼 - 惠特尼U检验进行统计分析。供体和患者人口统计学特征相似。两组在移植后肝脏生化指标、并发症发生率、急性排斥反应发作次数和死亡率方面未观察到统计学上的显著差异。所有患者保存溶液的平均输注量为1000±400 mL（范围为500 - 2000 mL）。使用HTK溶液时，这些容量对应的成本节省为每升148美元。总之，UW溶液和HTK溶液在灌注活体供肝移植物方面同样有效且安全；然而，使用HTK溶液可显著节省成本。
