Introduction: Outcomes of pancreas transplantation are highly dependent on the quality of organ preservation. University of Wisconsin (UW) fluid was developed for pancreas transplant in the 1980’s and has been used historically, however, due to recent shortage Histidine-Tryptophan-Ketoglutarate solution (HTK) has been used as an alternative. This study looks at the clinical outcomes of pancreas transplants that were preserved using HTK solution.
Method: Data was collected on simultaneous pancreas kidney transplants (SPK) performed in our unit between 2013-2023. The outcomes of those preserved with HTK versus UW were compared. Continuous outcomes were compared using Mann–Whitney U tests, and binary outcomes using Fisher’s exact tests.
Results: 49 SPK transplants were included; 8 were preserved with HTK and 41 with UW. The median cold ischaemia time for UW cases was 9.8 hours, versus a median of 11.16 hours for HTK. This study demonstrates that there has been increased need to return to theatre within the first post-operative week from 21.95% with the use of UW, to 37.5% with HTK (P-value=0.38). Moreover, there was a non-significant trend to a rise in CRP levels in the immediate post-operative period. The median CRP level at 3 days was 123.5 mg/L with HTK, versus 80 mg/L with UW (P-value = 0.44).(Fig2) A slight increase in median hospital stay has also been noted (P-value=0.97), although again this was not significant.

Conclusion: We find a trend towards inferior clinical outcomes when the HTK solution was used, compared to the UW solution. Although this study is limited by a small sample size, the findings suggest UW remains the most effective solution for pancreas preservation.