Clinical Trials Compared CUSTODIOL® (HTK Solution) to University of Wisconsin (UW) Solution in Adult Liver Transplantation1,8,9
Biliary Complications Following Liver Transplantation in the Model for End-Stage LiverDiseases Era: Effect of Donor, Recipient and Technical Factors9
Among this study are findings in 256 decreased donor liver transplants. The bile leak rate was 18% and stricture rate 23%. Use of histidine-tryptophan ketoglutarate (HTK) versus University of Wisconsin (UW) solution was protective.
* Graft function in the first 5 days postimplant was characterized on the basis of blood chemistry as Good (GOT-max 50%); Fair (GOT 1000-2500 U/L, clotting factor support 2500 U/L, clotting factor support >2 days)
+ PDF = Initial Poor function & Primary Non Function
Custodiol® HTK in Extended Criteria Liver Donors
This study presents experience in a large number of SCD and ECD (698) adult cadaveric liver transplants.10
All liver enzymes were measured and graphed at 1, 7, 14 and 30 days post-transplant. Livers preserved with HTK have a higher initial AST and ALT in SCD and (P)ECD livers, whereas the UW-preserved livers have a higher AST and ALT in old donor livers. In all groups, these differences disappear by postoperative day 7.10
- HTK has a much lower viscosity that may result in better penetration of the microcirculation for a better flush. This may lead to a lower rate of biliary complications and may provide a more thorough flush.10
- HTK is protective against biliary complications when compared to UW.10
- … patient and graft survival between UW preserved and HTK preserved ECD livers are equivalent…10
* (P)EC = Physiologic extended criteria donors
ViaSpan is a registered trademark of Barr Laboratories, Inc.
CUSTODIOL® is a registered trademark of Dr. Franz Köhler Chemie GmbH, Alsbach-Hähnlein, Germany.
Liver Transplant Biliary Complications for Deceased Donor Grafts: Comparison of HTK and UW Solutions
W. A. Marshall¹, A. J. Tector¹, T. C. Borup1, R. S. Mangus¹ ¹Indiana University School Of Medicine,Surgery/Transplant,Indianapolis, IN, USA
Conclusion:
HTK liver graft preservation in deceased donors is associated with better graft survival, less imaging, less risk of biliary leak and intrahepatic stricture, and a lower risk of intrahepatic strictures in DCD grafts.