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A propensity score matched analysis of liver transplantation outcomes in the setting of preservation solution shortage
The recent shortage of the University of Wisconsin (UW) solution prompted increased utilization of histidine-tryptophan-ketoglutarate (HTK) solution for liver graft preservation. This contemporary study analyzed deceased donor liver transplant outcomes following preservation with HTK vs UW. Patients...
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| Published in: | American journal of transplantation 2024-04, Vol.24 (4), p.619-630 |
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| container_title | American journal of transplantation |
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| creator | Preston, William A. Pace, Devon J. Altshuler, Peter J. Yi, Misung Kittle, Haley D. Vincent, Sage A. Andreoni, Kenneth A. Frank, Adam M. Glorioso, Jaime M. Ramirez, Carlo G. Maley, Warren R. Shah, Ashesh P. Bodzin, Adam S. |
| description | The recent shortage of the University of Wisconsin (UW) solution prompted increased utilization of histidine-tryptophan-ketoglutarate (HTK) solution for liver graft preservation. This contemporary study analyzed deceased donor liver transplant outcomes following preservation with HTK vs UW. Patients receiving deceased donor liver transplantations between January 1, 2019, and June 30, 2022, were retrospectively identified utilizing the Organ Procurement and Transplant Network database, stratified by preservation with HTK vs UW, and a propensity score matching analysis was performed. Outcomes assessed included rates of primary nonfunction, graft survival, and patient survival. There were 4447 patients in each cohort. Primary nonfunction occurred in 60 (1.35%) patients in the HTK group vs 25 (0.54%) in the UW group (P < .001). HTK was associated with lower 90-day graft survival (94.39% vs 96.09%; P < .001) and 90-day patient survival (95.97% vs 97.38%; P = .001). Unmatched donation after cardiac death-specific analysis of HTK vs UW demonstrated respective rates of primary nonfunction of 1.63% vs 0.82% (P = .20), 90-day graft survival of 92.50% vs 95.29% (P = .069), and 90-day patient survival of 93.90% vs 96.35% (P = .077). These results suggest that HTK may not be an equivalent preservation solution for deceased donor liver transplantation.
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| doi_str_mv | 10.1016/j.ajt.2023.10.028 |
| format | article |
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[Display omitted]</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1016/j.ajt.2023.10.028</identifier><identifier>PMID: 37940005</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Allopurinol ; Glucose ; Glutathione ; histidine-tryptophan-ketoglutarate (HTK) ; Humans ; Insulin ; Liver Transplantation ; Living Donors ; Mannitol ; Organ Preservation Solutions ; Potassium Chloride ; preservation solution ; primary nonfunction (PNF) ; Procaine ; Propensity Score ; Retrospective Studies ; survival ; University of Wisconsin (UW)</subject><ispartof>American journal of transplantation, 2024-04, Vol.24 (4), p.619-630</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-3c310c062e1004d0ec2bb2bb5ff1ead7d380cd632341ebd63684f0bc6bca77753</citedby><cites>FETCH-LOGICAL-c396t-3c310c062e1004d0ec2bb2bb5ff1ead7d380cd632341ebd63684f0bc6bca77753</cites><orcidid>0000-0003-0668-6165 ; 0000-0002-4843-2940 ; 0000-0001-9286-4161 ; 0009-0000-9651-4556 ; 0000-0002-4282-5313 ; 0000-0002-4007-5408 ; 0000-0001-6122-935X ; 0000-0001-6255-2087 ; 0009-0001-7522-4426 ; 0000-0002-2993-0012 ; 0000-0002-2019-1364</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1600613523008304$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,786,790,3568,27957,27958,45815</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37940005$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Preston, William A.</creatorcontrib><creatorcontrib>Pace, Devon J.</creatorcontrib><creatorcontrib>Altshuler, Peter J.</creatorcontrib><creatorcontrib>Yi, Misung</creatorcontrib><creatorcontrib>Kittle, Haley D.</creatorcontrib><creatorcontrib>Vincent, Sage A.</creatorcontrib><creatorcontrib>Andreoni, Kenneth A.</creatorcontrib><creatorcontrib>Frank, Adam M.</creatorcontrib><creatorcontrib>Glorioso, Jaime M.</creatorcontrib><creatorcontrib>Ramirez, Carlo G.</creatorcontrib><creatorcontrib>Maley, Warren R.</creatorcontrib><creatorcontrib>Shah, Ashesh P.</creatorcontrib><creatorcontrib>Bodzin, Adam S.</creatorcontrib><title>A propensity score matched analysis of liver transplantation outcomes in the setting of preservation solution shortage</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>The recent shortage of the University of Wisconsin (UW) solution prompted increased utilization of histidine-tryptophan-ketoglutarate (HTK) solution for liver graft preservation. This contemporary study analyzed deceased donor liver transplant outcomes following preservation with HTK vs UW. Patients receiving deceased donor liver transplantations between January 1, 2019, and June 30, 2022, were retrospectively identified utilizing the Organ Procurement and Transplant Network database, stratified by preservation with HTK vs UW, and a propensity score matching analysis was performed. Outcomes assessed included rates of primary nonfunction, graft survival, and patient survival. There were 4447 patients in each cohort. Primary nonfunction occurred in 60 (1.35%) patients in the HTK group vs 25 (0.54%) in the UW group (P < .001). HTK was associated with lower 90-day graft survival (94.39% vs 96.09%; P < .001) and 90-day patient survival (95.97% vs 97.38%; P = .001). Unmatched donation after cardiac death-specific analysis of HTK vs UW demonstrated respective rates of primary nonfunction of 1.63% vs 0.82% (P = .20), 90-day graft survival of 92.50% vs 95.29% (P = .069), and 90-day patient survival of 93.90% vs 96.35% (P = .077). These results suggest that HTK may not be an equivalent preservation solution for deceased donor liver transplantation.
[Display omitted]</description><subject>Allopurinol</subject><subject>Glucose</subject><subject>Glutathione</subject><subject>histidine-tryptophan-ketoglutarate (HTK)</subject><subject>Humans</subject><subject>Insulin</subject><subject>Liver Transplantation</subject><subject>Living Donors</subject><subject>Mannitol</subject><subject>Organ Preservation Solutions</subject><subject>Potassium Chloride</subject><subject>preservation solution</subject><subject>primary nonfunction (PNF)</subject><subject>Procaine</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>survival</subject><subject>University of Wisconsin (UW)</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLxDAUhYMovn-AG8nSzYw3SV_iSsQXCG50HdL01snQNjU3HZh_b4aqSyGQk_CdA-cwdiFgKUAU1-ulWcelBKnSewmy2mPHogBYFCJT-39a5UfshGgNIEpZyUN2pMqbDADyY7a542PwIw7k4paT9QF5b6JdYcPNYLotOeK-5Z3bYOAxmIHGzgzRROcH7qdofY_E3cDjCjlhjG743BnGgIRhM3Pku2kWKx-i-cQzdtCajvD85z5lH48P7_fPi9e3p5f7u9eFVTdFXCirBFgoJAqArAG0sq7TydtWoGnKRlVgm0JJlQmskyiqrIXaFrU1ZVnm6pRdzbmp5NeEFHXvyGKXKqCfSMuqqkCJPFMJFTNqgycK2OoxuN6ErRagd3PrtU5z693cu680d_Jc_sRPdY_Nn-N33wTczgCmkhuHQZN1OFhsXEAbdePdP_Hfy-eTYA</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Preston, William A.</creator><creator>Pace, Devon J.</creator><creator>Altshuler, Peter J.</creator><creator>Yi, Misung</creator><creator>Kittle, Haley D.</creator><creator>Vincent, Sage A.</creator><creator>Andreoni, Kenneth A.</creator><creator>Frank, Adam M.</creator><creator>Glorioso, Jaime M.</creator><creator>Ramirez, Carlo G.</creator><creator>Maley, Warren R.</creator><creator>Shah, Ashesh P.</creator><creator>Bodzin, Adam S.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0668-6165</orcidid><orcidid>https://orcid.org/0000-0002-4843-2940</orcidid><orcidid>https://orcid.org/0000-0001-9286-4161</orcidid><orcidid>https://orcid.org/0009-0000-9651-4556</orcidid><orcidid>https://orcid.org/0000-0002-4282-5313</orcidid><orcidid>https://orcid.org/0000-0002-4007-5408</orcidid><orcidid>https://orcid.org/0000-0001-6122-935X</orcidid><orcidid>https://orcid.org/0000-0001-6255-2087</orcidid><orcidid>https://orcid.org/0009-0001-7522-4426</orcidid><orcidid>https://orcid.org/0000-0002-2993-0012</orcidid><orcidid>https://orcid.org/0000-0002-2019-1364</orcidid></search><sort><creationdate>202404</creationdate><title>A propensity score matched analysis of liver transplantation outcomes in the setting of preservation solution shortage</title><author>Preston, William A. ; 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This contemporary study analyzed deceased donor liver transplant outcomes following preservation with HTK vs UW. Patients receiving deceased donor liver transplantations between January 1, 2019, and June 30, 2022, were retrospectively identified utilizing the Organ Procurement and Transplant Network database, stratified by preservation with HTK vs UW, and a propensity score matching analysis was performed. Outcomes assessed included rates of primary nonfunction, graft survival, and patient survival. There were 4447 patients in each cohort. Primary nonfunction occurred in 60 (1.35%) patients in the HTK group vs 25 (0.54%) in the UW group (P < .001). HTK was associated with lower 90-day graft survival (94.39% vs 96.09%; P < .001) and 90-day patient survival (95.97% vs 97.38%; P = .001). Unmatched donation after cardiac death-specific analysis of HTK vs UW demonstrated respective rates of primary nonfunction of 1.63% vs 0.82% (P = .20), 90-day graft survival of 92.50% vs 95.29% (P = .069), and 90-day patient survival of 93.90% vs 96.35% (P = .077). These results suggest that HTK may not be an equivalent preservation solution for deceased donor liver transplantation.
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| subjects | Allopurinol Glucose Glutathione histidine-tryptophan-ketoglutarate (HTK) Humans Insulin Liver Transplantation Living Donors Mannitol Organ Preservation Solutions Potassium Chloride preservation solution primary nonfunction (PNF) Procaine Propensity Score Retrospective Studies survival University of Wisconsin (UW) |
| title | A propensity score matched analysis of liver transplantation outcomes in the setting of preservation solution shortage |
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