Hesse U J, Troisi R, Jacobs B, Berrevoet F, De Laere S, Maene L, Vanden Broucke C, de Hemptinne B
Department of Surgery, University of Gent, Belgium.
Transplantation. 1998 Nov 15;66(9):1137-41. doi: 10.1097/00007890-199811150-00004.
Histidine-tryptophan-ketoglutarate (HTK) has been used for experimental and clinical cardiac, renal, and liver transplantation. No experience exists in either experimental or clinical pancreas transplantation.
In the present study, the solution was employed to flush segmental pancreatic grafts and to autotransplant the grafts after 24, 48, and 72 hr of cold storage in a porcine model. The results were compared to those obtained from animals receiving pancreatic grafts flushed and preserved with UW (University of Wisconsin) solution.
A total of 10 landrace pigs received a graft stored with HTK solution for 24 hr, and 6 animals received a graft stored with UW solution for 24 hr. Daily blood glucose levels were normoglycemic (i.e., blood glucose < 150 mg/dl), and glucosuria was absent in all transplant animals. Intravenous glucose tolerance tests were comparable to two unoperated controls. Seven totally pancreatectomized, nontransplant diabetic controls exhibited daily hyperglycemia, glucosuria (i.e., > 1,000 mg/dl) and highly impaired intravenous glucose tolerance tests (mean K-values of -0.52+/-0.19 vs. -1.25+/-0.46 for HTK, -1.30+/-0.81 for UW, and -1.53+/-0.81 for controls, P-value vs. diabetic <0.01). The changes in wet weight between flushing and reperfusion were +2.22+/-2.84 g for HTK and -1.40+/-2.70 g for UW stored grafts (P=0.034). After 48 hr of storage with HTK, 4/17 grafts were functioning and 1/11 recipients of grafts stored with UW were normoglycemic. All grafts stored for 72 hr in either HTK (n=3) or UW (n=3) uniformly failed to render the recipients normoglycemic.
It is concluded that preservation of segmental pancreatic autografts for 24 hr with HTK solution provides reliable graft function, as does preservation with UW solution associated with an increase in wet weight after HTK preservation. Cold preservation with HTK and UW is feasible for 48 hr; however, the success rate is equally reduced with HTK and UW solution. Cold storage for 72 hr in either HTK or UW solution results in uniform graft failure in this model.
组氨酸-色氨酸-酮戊二酸（HTK）已用于实验性和临床心脏、肾脏及肝脏移植。在实验性或临床胰腺移植方面尚无相关经验。
在本研究中，该溶液用于冲洗节段性胰腺移植物，并在猪模型中于冷藏24、48和72小时后对移植物进行自体移植。将结果与接受用威斯康星大学（UW）溶液冲洗和保存的胰腺移植物的动物所获结果进行比较。
共有10头长白猪接受了用HTK溶液保存24小时的移植物，6只动物接受了用UW溶液保存24小时的移植物。所有移植动物的每日血糖水平均为正常血糖（即血糖<150mg/dl），且无糖尿。静脉葡萄糖耐量试验与两个未手术的对照相当。7只完全胰腺切除的非移植糖尿病对照表现出每日高血糖、糖尿（即>1000mg/dl）以及静脉葡萄糖耐量试验严重受损（HTK组的平均K值为-0.52±0.19，UW组为-1.30±0.81，对照组为-1.53±0.81，与糖尿病组相比P值<0.01）。冲洗与再灌注之间的湿重变化，HTK保存的移植物为+2.22±2.84g，UW保存的移植物为-1.40±2.70g（P=0.034）。用HTK保存48小时后，17个移植物中有4个功能良好，用UW保存的移植物的11个受体中有1个血糖正常。在HTK（n=3）或UW（n=3）中保存72小时的所有移植物均未能使受体血糖正常。
得出结论，用HTK溶液保存节段性胰腺自体移植物24小时可提供可靠的移植物功能，用UW溶液保存也如此，且HTK保存后湿重增加。用HTK和UW进行冷保存48小时是可行的；然而，HTK和UW溶液的成功率同样降低。在本模型中，用HTK或UW溶液冷藏72小时会导致移植物均失败。
