Abstract: PUB231
A Real-World Indian Study of Outcomes with Two Variants of Histidine-Tryptophan-Ketoglutarate (HTK) Preservation Solutions in Kidney Transplantation
Session Information
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Cabral, Katherine Anntoinette, Nanavati Max Super Speciality Hospital, Mumbai, MH, India
- Kothari, Jatin Piyush, Nanavati Max Super Speciality Hospital, Mumbai, MH, India
- Algeri, Rashmi, Nanavati Max Super Speciality Hospital, Mumbai, MH, India
- Kothari, Natasha, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
- Billa, Viswanath, Apex Kidney Care, Mumbai, MH, India
- Bodke, Sachin Yadav, Indian Institute of Technology Bombay, Mumbai, MH, India
- Bichu, Shrirang, Apex Kidney Care, Mumbai, MH, India
Background
Kidney transplantation remains the most definitive treatment for ESKD . In India, the disparity between organ demand/supply and donor availability makes optimization of graft outcomes critically important. Organ Preservation is a major determinant of immediate transplant success.HTK solution is widely used for organ preservation because of its low viscosity and favorable characteristics; However, evidence supporting its use in the Indian settings remains limited.
Methods
This retrospective observational study evaluated 152 consecutive kidney transplant recipients at Nanavati Max Hospital between November 2021-2025. Eligible patients included adult recipients of kidneys preserved using HTK solution with complete post-transplant follow-up data upto 30 days. Primary endpoints included primary non-function (PNF), delayed graft function (DGF), and renal function following transplantation. Secondary endpoints included acute rejection, graft loss and comparison between two HTK variants , Custodiol (original )and Graftsol (Indian) solutions used.
Results
A total of 152 kidney transplant recipients preserved with HTK solutions ( Custodiol and Graftsol )were studied .The cohort comprised of 128 related//swap and 24 deceased-donor transplants. No case of PNF was observed in either group. DGF occurred in 9/52 (17.3%; 95% CI 9.4–29.7) Custodiol and 22/100 (22.0%; 95% CI 15.0–31.1) Graftsol recipients (p = 0.53). Acute rejection within 30 days was observed in 6/52 (11.5%; 95% CI 5.4–23.0) versus 6/100 (6.0%; 95% CI 2.8–12.5) recipients respectively (p = 0.34). Post-transplant dialysis or PLEX were required in 7/52 (13.5%) Custodiol and 12/100 (12.0%) Graftsol patients (p = 0.80), and indication- driven allograft biopsy within 30days was performed in 4/52 (7.7%) and 10/100 (10.0%) respectively (p = 0.77). Thirty-day mortality was 0/52 (0.0%) in the Custodiol group and 2/100 (2.0%; 95% CI 0.6-7.0) in the Graftsol group (p = 0.31)
Conclusion
HTK use is associated with acceptable short-term graft and patient outcomes, DGF and acute rejection, with no cases of primary non-function.Custodiol and Graftsol variants of HTK were associated with similar rates of DGF, acute rejection, and biopsy proven rejection within 30 days. These findings support the optimal use of Indian HTK solution(Graftsol) with significant cost savings in our setting.
Acknowledgment
Emcure Pharmaceuticals and Nanavati Max hospital