Despite the increased use of HTK (histidine-tryptophan-ketoglutarate) in liver transplantation over the past decade (currently used in ~30% of liver transplants in Europe and the US), clinical data continue to demonstrate the advantages of UW (University of Wisconsin) solution over HTK.
A review of randomized controlled trials, observational studies, registry data, and clinical studies found:
No difference between solutions in early graft survival in patients receiving deceased donor livers
Poorer allograft outcomes for HTK with longer cold ischemia times (CIT) and donation after cardiac death (DCD) grafts compared with UW
HTK is independently associated with an increased risk of graft loss
HTK is associated with a higher incidence of graft losses from primary non-function/dysfunction or biliary complications compared with UW
Additionally, no studies have shown HTK to be superior to UW solution. The authors concluded that even if it is reasonable to use HTK for standard criteria grafts, given the unpredictable nature of liver transplantation, organs may frequently receive CIT of >8 hours when HTK has repeatedly shown to be inferior to UW.
Stewart ZA., Am J Transplant. 2015;15(2):295–6.