ABDOMINAL
STUDIES
Comparison of histidine-tryptophan ketoglutarate solution and University of Wisconsin solution in prolonged cold preservation of kidney allografts (Agarwal, et al., 2006)
This single-center analysis of 149 deceased donor kidney transplants with cold ischemic times over 16 hours (including a subset over 24 hours) found that Histidine-Tryptophan-Ketoglutarate (HTK) solution achieved comparable graft and patient survival to University of Wisconsin (UW) solution, with significantly lower rates of delayed graft function (24% vs 56%, p = 0.004) . In the >24-hour subgroup, HTK preserved kidneys demonstrated a trend toward improved graft survival (97% vs 82%) and better early function, leading the authors to conclude that HTK is not inferior—and may offer superior protection—for prolonged cold storage of kidney allografts.
Donor Comparison of HTK and UW in Living‑Donor Liver Grafts (Moray et al., 2006)
This study comparing living-donor liver grafts preserved with either HTK or UW found both solutions to be equally effective and safe, while noting that HTK provided significant cost savings. The findings support the use of HTK in living-donor liver transplantation without compromising graft outcome.
Comparison of HTK vs UW in Liver Transplantation Outcomes (Erhard et al., 1994)
In this liver transplant study, HTK and UW solutions were found to both be appropriate for clinical use, even with cold ischemia times of more than 15 hours. The data suggest that HTK is a viable alternative to UW for liver graft preservation under extended cold storage conditions.
Preservation solutions for static cold storage in donation after circulatory death and donation after brain death liver transplantation in the United States (Cotter, et al., 2022)
This national UNOS/OPTN analysis of over 88,000 liver transplants (2006–2020) found that Histidine-Tryptophan-Ketoglutarate (HTK) solution produced equal or better graft survival compared with University of Wisconsin (UW), including in donation after circulatory death (DCD) cases. In the most recent era (2016–2020), HTK demonstrated superior 1- and 5-year graft survival (89.7% vs 85.9%; 74.3% vs 70.8%; p = 0.005), leading the authors to conclude that HTK is non-inferior—and potentially advantageous—for both DCD and DBD liver preservation, challenging prior ILTS guidance against its use.
Comparison of Histidine-Tryptophan-Ketoglutarate Solution and University of Wisconsin Solution in Intestinal and Multivisceral Transplantation (Mangus et al., 2008)
In a retrospective review of 54 patients (57 grafts) undergoing isolated small bowel, modified multivisceral and full multivisceral transplantation between 2003-2007 — preserved either with the Histidine‑Tryptophan‑Ketoglutarate solution (HTK) (n = 37) or the University of Wisconsin solution (UW) (n = 22) — no statistically significant difference was observed in early graft function, endoscopic appearance, number of rejection episodes, or patient/graft survival at 30 and 90 days.
Safety and efficacy of living donor liver preservation with HTK solution (Ringe et al, 2005)
This prospective study of 24 living donor liver transplants found that preservation with Histidine-Tryptophan-Ketoglutarate (HTK) solution was safe and effective, with all grafts showing good functional recovery and no cases of primary nonfunction or late ischemic biliary lesions. The authors conclude that HTK offers multiple advantages—such as low potassium content, ease of use, superior biliary protection, and lower cost—making it a highly suitable preservation solution for living donor liver transplantation.
Deceased Donor Flush Volume Similar for Histidine-Tryptophan-Ketoglutarate and University of Wisconsin at a Single US Organ Procurement Organization: Adult and Pediatric Data (Mangus, A. et al., 2023)
This large single-OPO study compared flush volumes of Histidine-Tryptophan-Ketoglutarate (HTK) and University of Wisconsin (UW) solutions in over 1,000 liver and pancreas procurements performed by 70 U.S. centers. It found that HTK was used in the majority of cases, required significantly lower flush volumes than UW (≈4.5 L vs 7 L for adult livers) with no compromise in practice outcomes, supporting low-volume HTK use as a safe and cost-saving strategy for abdominal organ preservation.