COLD PRESERVATION OF THE PORCINE PANCREAS WITH HISTIDINE-TRYPTOPHAN-KETOGLUTARATE SOLUTION

Background. Histidine-tryptophan-ketoglutarate (HTK) has been used for experimental and clinical cardiac, renal, and liver transplantation. No experience exists in either experimental or clinical pancreas trans plantation. Methods. In the present study, the solution was employed t o flush segmental pancreatic grafts and to autotransplant the grafts a fter 24, 48, and 72 hr of cold storage in a porcine model. The results were compared to those obtained from animals receiving pancreatic gra fts flushed and preserved with UW (University of Wisconsin) solution. Results. A total of 10 landrace pigs received a graft stored with HTK solution for 24 hr, and 6 animals received a graft stored with UW solu tion for 24 hr. Daily blood glucose levels were normoglycemic (i.e., b lood glucose <150 mg/dl), and glucosuria was absent in all transplant animals. Intravenous glucose tolerance tests were comparable to two un operated controls. Seven totally pancreatectomized, nontransplant diab etic controls exhibited daily hyperglycemia, glucosuria (i.e., >1,000 mg/dl) and highly impaired intravenous glucose tolerance tests (mean K -values of -0.52+/-0.19 vs. -1.25+/-0.46 for HTK, -1.30+/-0.81 for UW, and -1.53+/-0.81 for controls, P-value vs. diabetic <0.01). The chang es in wet weight between flushing and reperfusion were +2.22+/-2.84 g for HTK and -1.40+/-2.70 g for UW stored grafts (P=0.034). After 48 hr of storage with HTK, 4/17 grafts were functioning and 1/11 recipients of grafts stored with UW were normoglycemic. All grafts stored for 72 hr in either HTK (n=3) or UW (n=3) uniformly failed to render the rec ipients normoglycemic. Conclusions. It is concluded that preservation of segmental pancreatic autografts for 24 hr with HTK solution provide s reliable graft function, as does preservation with UW solution assoc iated with an increase in wet weight after HTK preservation. Cold pres ervation with HTK and UW is feasible for 48 hr; however, the success r ate is equally reduced with HTK and UW solution. Cold storage for 72 h r in either HTK or UW solution results in uniform graft failure in thi s model.