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Article
Increased Primary Non-Function in Transplanted Deceased-Donor Kidneys Flushed with Histidine-Tryptophan-Ketoglutarate Solution
American Journal of Transplantation
  • R. Brian Stevens, Wright State University
  • Jill Y. Skorupa
  • Theodore H. Rigley
  • Govardhana R. Yannam
  • Kathleen J. Nielsen
  • M. E. Schriner
  • Anna J. Skorupa
  • A. Murante
  • E. Holdaway
  • Lucile E. Wrenshall, Wright State University - Main Campus
Document Type
Article
Publication Date
5-1-2009
Abstract
Histidine-Tryptophan-Ketoglutarate (HTK) solution is increasingly used to flush and preserve organ donor kidneys, with efficacy claimed equivalent to University of Wisconsin (UW) solution. We observed and reported increased graft pancreatitis in pancreata flushed with HTK solution, which prompted this review of transplanting HTK-flushed kidneys. We analyzed outcomes of deceased-donor kidneys flushed with HTK and UW solutions with a minimum of 12 months follow-up, excluding pediatric and multi-organ recipients. We evaluated patient and graft survival and rejection rates, variables that might constitute hazards to graft survival and renal function. Two-year patient survival, rejection, renal function and graft survival were not different, but early graft loss (months) was worse in HTK-flushed kidneys (p < 0.03). A Cox analysis of donor grade, cold ischemic time, panel reactive antibodies (PRA), donor race, first vs. repeat transplant, rejection and flush solution showed that only HTK use predicted early graft loss (p < 0.04; relative risk = 3.24), almost exclusively attributable to primary non-function (HTK, n = 5 (6.30%); UW, n = 1 (0.65%); p = 0.02). Delayed graft function and early graft loss with HTK occurred only in lesser grade kidneys, suggesting it should be used with caution in marginal donors.
DOI
10.1111/j.1600-6143.2009.02624.x
Citation Information
R. Brian Stevens, Jill Y. Skorupa, Theodore H. Rigley, Govardhana R. Yannam, et al.. "Increased Primary Non-Function in Transplanted Deceased-Donor Kidneys Flushed with Histidine-Tryptophan-Ketoglutarate Solution" American Journal of Transplantation Vol. 9 Iss. 5 (2009) p. 1055 - 1062 ISSN: 16006135
Available at: http://works.bepress.com/lucile_wrenshall/63/