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Evaluation of the Modified Htk Solution in Pancreas Transplantation - an Experimental Model Publisher Pubmed



Esmaeilzadeh M1 ; Fonouni H1 ; Golriz M1 ; Majlesara A1 ; Kuttymuratov G1 ; Bergmann F2 ; Jarahian P1 ; Khazaeipour Z3 ; Faridar A1 ; Rad MT1 ; Longerich T2 ; Gebhard MM4 ; Mehrabi A1
Authors
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Authors Affiliations
  1. 1. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Germany
  2. 2. Department of Pathology, University of Heidelberg, Heidelberg, Germany
  3. 3. Research Development Center, Tehran University of Medical Science, Tehran, Iran
  4. 4. Department of Experimental Surgery, University of Heidelberg, Heidelberg, Germany

Source: Asian Journal of Surgery Published:2016


Abstract

Introduction One of the great challenges in pancreas transplantation is the ischemia reperfusion injury. It is mentioned that free oxygen and/or nitrogen radicals play a prominent role in this phase. To minimize this problem, a modified histidine-tryptophan-ketoglutarate (HTK) solution that contains modified antioxidants has been developed. Our aim was to evaluate this solution in improving the viability of the pancreas in comparison with standard HTK and University of Wisconsin (UW) solutions in a porcine model of pancreas transplantation. Materials and methods Twenty-three Landrace pigs were divided into three identical groups. After a 10-hour preservation time at 4°C, the pancreas was implanted in the organs of the recipients in a standardized manner. Serum parameters were assessed prior to and after implantation on the 1st postoperative day, 3rd postoperative day, and 7th postoperative day. Furthermore, three biopsies were taken: prior to and after reperfusion, and on Day 7 to assess the grafts. Results An analysis of serum glucose among the three groups showed no significant differences. Evaluation of the insulin levels showed no significant difference between the modified and standard HTK groups; however, differences between HTK and UW were significant (p = 0.004 in favor of UW solutions). The histopathological results showed a trend of a higher grade of rejection of pancreas tissue in the UW group compared to both HTK groups. Conclusion The modified HTK solution could preserve the pancreas for the preservation of the graft with similar results to those observed for standard solutions without any significant difference. The trend showed that the pathological finding in the UW group was not as good as that in the modified HTK and standard HTK groups. Copyright © 2015, Asian Surgical Association. Published by Elsevier Taiwan LLC.