Current Trends in Organ Preservation Solutions for Pancreas Transplantation: A Single-Center Retrospective Study
Joana Ferrer, Emma Folch‐Puy, Juan José Lozano, Pedro Ventura‐Aguiar, Gabriel Cárdenas, David Paredes, Ángeles García‐Criado, Josep Antoni Bombí, Rocío García-Pérez, M.Á. López-Boado, R. Rull, Enric Esmatjes, M.J. Ricart, Fritz Diekmann, Constantino Fondevila, Laureano Fernández‐Cruz, Josep Fuster, Juan Carlos García‐Valdecasas
Abstract
Due to the high vulnerability of the pancreas to ischemia-reperfusion injury, choices regarding preservation solution markedly affect pancreas transplant success. A retrospective single-center analysis of 380 pancreas transplants (2000–2019) was performed to correlate current preservation solutions with transplant outcomes. Early graft failure requiring transplantectomy within 30 days post-transplant occurred in 7.5% for University of Wisconsin (UW) group ( n = 267), 10.8% of Celsior (CS) group ( n = 83), 28.5% of Histidine-Tryptophan-Ketoglutarate (HTK) group ( n = 7), and none for Institut Georges Lopez-1 (IGL-1) group ( n = 23). The most common causes of technical failures in this cohort included abdominal hemorrhage (8.4%); graft pancreatitis (3.7%); fluid collections (2.6%); intestinal complications (6.6%); and vascular thrombosis (20.5%). Although IGL-1 solution provided lower surgical complication rates, no significant differences were found between studied groups. Nevertheless, HTK solution was associated with elevated pancreatitis rates. The best graft survival was achieved at 1 year using UW and IGL-1, and at 3 and 5 years using IGL-1 ( p = 0.017). There were no significant differences in patient survival after a median follow-up of 118.4 months. In this setting therefore, IGL-1 solution appears promising for perfusion and organ preservation in clinical pancreas transplantation, compared to other commonly used solutions.