I have a question about preservation solution in regards to the type of solution utilized. In many transplant centers Wisconsin Solution or Custodiol (HTK solution) are used for kidney preservation. Nevertheless, in the absence of one of these standard preservation solutions, some peple use Hartman Solution (Lactated Ringer) adding to it some electrolytes such as potassium, and other substances as manitol, lidocaine, etc. Is it justified to use the handly prepared preservation solutions with Hartman and other electrolytes?
The principles of organ preservation are flushing, cooling, and pharmacologic intervention. University of Wisconsin (UW) solution is currently considered the standard preservation solution for livers, kidneys, and pancreases. The osmotic concentration is achieved by the administration of metabolically inert substrates like lactobinat and raffinose. Other components include hydroxyethylstarch as a colloid carrier, oxygen radical scavengers, glutathione, allopurinol, and adenosine. Histidine-Tyrptophan-Ketoglutarate (HTK) solution is another option which has shown similar safety and efficacy at least for lower cold ischemia times. Its contents include histidine, mannitol, tryptophan and alpha-ketoglutaric acid. It also contains low concentrations of sodium, potassium, and magnesium. Histidine serves as a buffer, and tryptophan, histidine, and mannitol act as oxygen free-radical scavengers. There is some evidence that using cold lactated Ringers with additives can be safely used for short-term cold preservation of kidneys from living renal donors and is a cost-effective option but only in that circumstance.