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Tacrolimus + HTK solution is an experimental ex vivo organ preservation treatment developed by the Ludwig-Maximilians - University of Munich. It consists of the calcineurin inhibitor tacrolimus dissolved in Histidine-Tryptophan-Ketoglutarate (HTK) preservation solution. This combination is used as a rinse for marginal liver grafts (extended criteria donors) prior to transplantation to mitigate ischemia-reperfusion injury (IRI). Tacrolimus acts by binding to FKBP12 to inhibit calcineurin, thereby preventing T-cell activation and reducing the inflammatory response associated with reperfusion. The HTK solution provides a cold storage environment that maintains electrolyte balance and buffers against acidosis during the ischemic period. This intervention was evaluated in the prospective multicenter TOP-Study (NCT01564095).
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