Comparison of Histidine- Tryptophan- Ketoglutarate Solution (HTK) and University of Wisconsin Solution (UW) in adult Liver transplantation

Background : A safe and effective preservation solution is a precondition for successful liver transplantation (LTx). This study compares University of Wisconsin (UW) and Histidine- Tryptophan-ketoglutarate HTK solutions in liver transplantation

Patients/Methods: We retrospectively reviewed medical records of 137 primary cadaveric LTx performed between Jauary 2003 and December 2006 at our institution. 68 grafts were harvested using UW and 69 using HTK. Recipients were managed similarly with regard to operative techniques and immunosuppression. Donor data including serum transaminases, serum sodium, ICU stay and assessed macroscopic liver quality were collected. Recipient serum transaminases were collected at postoperative days 1, 7, 14 and 30. Biliary- and vascular complications, patient and graft survival were compared..

Results: Mean serum transaminase levels were slightly higher in the HTK group at day 1 (NS) but were comparable thereafter. Primary non-function occured in 1 patient in each group. 6 patients in the UW and in 7 patients in the HTK group, were retransplanted. Biliary complication rates were similar in the UW and HTK groups (26.5% and 30.8%, respectively). There were 5 (7.2%) arterial complications in the HTK and 2 (2.9%) in the UW group (p<0.05). Mean follow-up was25 months. Graft survival at 1, 12, and 36 month was 90%, 78%, 75%, and 90%, 71%, and 71% in the UW and HTK group, respectively. 1, 12, 36 month patient survival was 93%, 78%, 75% and 93%, 78%, 78%, in the UW and HTK group, respectively.

Conclusions: There were no significant differences in graft and patient survival between the two groups. Biliary and arterial complication rates were also comparable. UW and HTK solutions seem to be equally safe and effective in the preservation of liver grafts.