Organ preservation solutions for whole organ pancreas transplantation.

PURPOSE OF REVIEW: University of Wisconsin solution is currently the most commonly used solution for abdominal organ transplantation and is the standard to which newer solutions are compared. In recent years, we have witnessed the introduction of two alternative preservation solutions, histidine-tryptophan-ketoglutarate (HTK) solution and Celsior solution, into the transplant clinical arena. In this article, these solutions will be introduced, compared to University of Wisconsin solution and studies comparing their clinical outcomes to those of University of Wisconsin solution will be reviewed.

RECENT FINDINGS: HTK solution has been scrutinized in the literature with two reports suggesting a possible increased incidence of allograft pancreatitis, but it has also been demonstrated in several single-center retrospective studies and in one randomized prospective study to be clinically similar to University of Wisconsin solution, at least with lower flush volumes and shorter ischemic times. Celsior solution has been compared in four studies (three of which were prospective randomized studies) to University of Wisconsin solution and found to be clinically similar, but all of these studies reported reasonably brief ischemia times.

SUMMARY: All three preservation solutions seem to perform equally well with shorter ischemia times (<12 h). There remains controversy regarding both Celsior solution and HTK solution with longer ischemia times, whereas University of Wisconsin solution seems to perform well even for more than 24 h of preservation.