HEPATIC PRESERVATION WITH HISTIDINE-TRYPTOPHAN-KETOGLUTARATE SOLUTIONIN LIVING-RELATED AND CADAVERIC LIVER-TRANSPLANTATION

1. Living-related liver transplantation has some advantages in the eva luation of novel clinical protocols, since many complicated factors af fecting initial graft function are almost uniform in grafts obtained f rom healthy donors. 2. To compare histidine-tryptophan-ketoglutarate ( HTK) and University of Wisconsin (UW) solution in terms of tissue oxyg enation in living-related liver transplantation, oxygen saturation of haemoglobin (SO2) in hepatic tissue and its heterogeneity (CV, coeffic ient of variation) were measured by near-infrared spectroscopy, The HT X and UW groups consisted of 15 and 49 successful transplants respecti vely, in which no statistical differences in background were observed. 3. In the HTK group, hepatic SO2 after portal vein reflow was higher (P<0.01) than that in the UW group, as was that after hepatic artery r eflow (P<0.05). In the UW group, hepatic SO2 remained at the lower lev el at the end of the operation. 4. Furthermore, the increase in CV aft er portal vein reflow was normalized after hepatic artery reflow in th e HTK group. However, the CV remained at a high level at the end of th e operation in the UW group. 5. Postoperative peak aspartate aminotran sferase level in the HTK group was lower than that in the UW group (P< 0.05). 6. In cadaveric liver transplantation, higher hepatic SO2 and l ower CV of hepatic SO2 in the early phase after reperfusion compared w ith the UW group (n=18) were also observed in the HTK group (n=30) (P< 0.05). 7. In conclusion, recovery of tissue oxygenation and its hetero geneity after reperfusion in HTK-preserved livers were more rapid and homogeneous than in UW-preserved livers in living-related liver transp lantation. Accordingly, HTK solution may be a potential alternative to UW solution.