Eurotransplant Randomized Multicenter Kidney Graft Preservation Study Comparing HTK and UW and Euro-Collins J. de Boer, et al Transl Int (1999) 12: 447-453
This paper provided the basis for approval of Custodiol® in Kidney transplants in the United States. The study found Custodiol® and UW equivalent in kidney transplant, and both superior to Euro-Collins. This is a large, randomized trial that involved a total of 659 donors and 1180 transplants. 1 and 3 year graft survival were numerically higher for Custodiol®, though this was not statistically significant.
Comparison of Histidine-Tryptophan-Ketoglutarate Solution and University of Wisconsin Solution in Prolonged Cold Preservation in Kidney Allografts Avinash Agarwal, et al, Transplantation Volume 81, No. 3 February 15, 2006
This study compares UW to HTK for cold static storage of kidneys with cold ischemic times greater than 16 hours, and a subset analysis of CI over 24 hours. Graft and patient survival were similar in both groups, and the HTK cohort exhibited lower DGF. There was a trend towards improved survival in the HTK group with CI > 24 hours.
Comparison of Histidine-Tryptophan-Ketoglutarate and University of Wisconsin Solutions and Primary Preservation in Renal Allografts Undergoing Pulsatile Perfusion A, Agarwal, et al Transplantation Proceedings, 37, 2016-2019 (2005)
In this study from the Indiana University School of Medicine, UW and HTK were compared in cold preservation in kidneys that were subsequently put in pulsatile perfusion. 91 deceased renal and SKP transplants were performed. No significant differences were found in DGF, patient or graft survival. Volumes used were higher in the HTK group as anticipated.
Effects of Preservation Conditions and Temperature on Tissue Acidification in Canine Kidneys M. Kallerhoff et al, Transplantation, Vol. 39, No. 5 pp:485-489 (1985)
This older animal model paper is of interest as it investigates the influence of temperature on the degree of tissue acidification in the kidneys. Over the time of a transplant, temperature can vary significantly. Temperatures studies were 5, 15, 25, and 35ºC. The author found that HTK Solution guarantees satisfactory protection against damaging acidosis over the whole temperature range.
ALBRECHT, K. et al Impact of Preservation Solution on Early Function and Graft Survival in Cadaveric Renal Transplantation, Transplantation Proceedings, Vol. 25 No. 4 (August) 1993: pp 2561-2562
AMORTEGUI, J.D. et al, Comparison of University of Wisconsin (UW) and Histidine-Tryptophan-Ketoglutarate (HTK) Preservation Solutions in Renal Transplantation with Prolonged Cold Ischemia Time, Abstract # 1406, June 1, 2009
This abstract is a retrospective review of 200 kidney grafts that were cold preserved with HTK or UW solution (100 each) by a single OPO and transplanted as kidney-only organs in different Tx centers. Donor and recipient demographics, patient and graft survival at 1 year, incidence of acute rejection, DGF, and PNF were all considered and compared. The authors concluded that HTK and UW provide similar outcomes even in prolonged cold storage times.
DAEMEN, J.H.C. et al, Non-Heart-Beating Donor Program Contributes 40% of Kidneys for Transplantation, Transplantation Proceedings Vol. 28 No. 1 (February) 1996; pp 105-106
DAVIDSON, I.J., Renal Impact of Fluid Management with Colloids: A Comparative Review, European Journal of Anesthesiology, 2006 p. 1-18
DEBROY M. et al, Cost Effectiveness of the Use of HTK as an Alternative Preservation Solution in Live Donor Renal Transplantation, American Journal of Transplantation Supp 8 Vol. 4 2004 p. 242
ENGLESBE, M. et al, Does Using HTK Solution for Cold Preservation of Cadaveric Kidneys Save Money? Transplantation, Vol. 81 No. 12, June 27, 2006
GANDOLFO M. T. , et al, Impact of Ischemia Times on Kidney Transplant Outcomes, Transplantation, Vol. 83 No. 3, Feb 2007 p. 254
GROENEWOUD, A.F., et al, A Final Report of the Eurotransplant Randomised Multicenter Study Comparing Kidney Graft Preservation with HTK, UW, and EC Solution, 7th Congress of Europ. Soc. For Organ Transplantation, ESOT ’95, Vienna
GROENEWOUD, A.F., et al, A Preliminary Report of the HTK Randomized Multicenter Study Comparing Kidney Graft Preservation with HTK and EuroCollins Solutions, Transplant mt. 5 (Suppl. 1), (1992), 429-432
GSCHWEND, J.E., et al, Continuous in-Situ Cold Preservation with Histidine Tryptophan Ketoglutarate Solution in Nephron Sparing Surgery in Renal Tumors, J. of Urology, 154 (1995), 1307-1311
ISEMER, F.E., et al, Kidney Procurement with the HTK Solution of Bretschneider, Transplantation Proceedings, Vol. XX, No. 5, (Oct) 1988, 855-866
KALLERHOFF, M. et al Metabolic, Energetic and Structural Changes in Protected and Unprotected Kidneys at 1º C and 25 º C, Urological Research, 1988 16:57-62
KALLERHOFF, M., et al, Kidney Preservation in Situ and Conservative Treatment of Renal Cell Carcinoma: Application of HTK Solution (Custodiol® ), Investigative Urology V, Chapman + Hall, (1994)
KALLERHOFF, M., et al, Post-Ischemic Renal Function After Kidney Protection with HTK Solution of Bretschneider, Urol. Res. 14 (1986), 271-277
KALLERHOFF, M., et al, Short-Term Perfusion and “Equilibration” of Canine Kidneys with Protective Solutions, Urol. Res. 15 (1987), 5-12
KALLERHOFF, M., et al, A New Method for Conservative Renal Surgery – Experimental and Clinical First Results, Langenbecks Arch. Chir., 375 (1990), 340-346
KEHRER, G., et al, Postischemic Interrelations Between Energy Metabolism and Functional Recovery of Protected Canine Kidneys, Europ. J. Clin. Invest 19 (1989) 328-336
KLAUS, F. et al Kidney Transplantation with Belzer or Custodiol Solution: A Randomized, Prospective Study, Transplantation Proceedings, 39, 353-354 2007
LYNCH, R.J. et al, Comparison of Histidine-Tryptophan-Ketoglutarate and University of Wisconsin Preservation in Renal Transplantation, American Journal of Transplantation, 2008, 8: 567-573
This large study is a retrospective analysis comparing patient and graft outcomes of 475 living donor and 317 deceased donor transplants, half of which were preserved with HTK, with the same number of grafts preserved using UW solution. Multi-variate analysis revealed “HTK was associated with a significant risk reduction on the incidence of DGF.” Prolonged preservation time with HTK compared to UW was not associated with excess risk to the graft or patient. HTK demonstrated “efficacy similar to UW in terms of patient and graft survival.”
LYNCH, R. J. et al, Comparison of Outcomes with HTK and UW Solutions in Renal Transplantation, American Journal of Transplantation, 2008, 8: 1958
MANEKELLER, S. et al, Conditioning Predamaged Grafts after Cold Storage: Influence of Oxygen and Nutritive Stimulation, Transplantation International 19 (2006) p. 667-674
MOISIUK, Y. et al, Histidine-Tryptophan-Ketoglutarate versus Euro-Collins for Preservation of Kidneys from Non-Heart-Beating Donors, Transplantation Proceedings Vol. 28 No. 1 (February) 1996 p. 202
O’CALLAGHAN, J.M. et al, Preservation Solutions for Static Cold Storage of Kidney Allografts: A Systematic Review and Meta-Analysis, American Journal of Transplantation, October 2011.
PLAS, E., et al, Experience in Renal Autotransplantation: Analysis of a Clinical Series, British Journal of Urology(1996) 77: p 518-523
RAYHILL, S. et al Renal Transplantation: Surgical Procedure and Complications Urology Vol. 12 Part 1, (February) 2004 pp. 2-8
ROZIER, E. et al, Effects of Preservation Solution on Early Kidney Graft Function: Comparison of University of Wisconsin Solution vs. Histidine Tryptophan Ketoglutarate Solution, American Journal of Transplantation, Supp. 11 Vol. 5, 2005 #767
TRUSHKOV S. et al, Use of HTK Solution in Kidney Preservation Transplantation Proceedings, 35, 766 (2003)
WILSON, C.H. et al Comparison of HTK and Hypertonic Citrate to Intrarterial Cooling in Human Non-Heart-Beating Donors, Transplantation Proceedings, 39, 351-352 (2007)