& Preservation Solution

CUSTODIOL

®

Organ-Protective

HTK Solution

What is CUSTODIOL?

CUSTODIOLis a Histidine-Tryptophan-Ketoglutarate Solution (HTK), manufactured by Dr Franz Koehler Chemie GmbH and Koehler Pharmaceuticals Asia. It serves as a cardioplegia solution approved for use in both abdominal (kidney, pancreas, liver) and thoracic (heart) procedures.

A ready-to-use solution with no filters or additives needed, which can prevent any contamination in between mixing.

Also, the solution has a “water like” viscosity that enables an optimal perfusion of the microvasculature, resulting in easier diffusion.

CUSTODIOL is a preferred protection solution in over 90 countries worldwide, widely utilised in both organ transplantation and cardiac surgery procedures that require effective perfusion and flushing.

The specialised formulation supports optimal organ preservation during transplantation, while providing myocardial protection during cardiac surgeries.

As a manufacturer of CUSTODIOL HTK solution, we provide high quality standards according to GMP condition.

Why Choose CUSTODIOL?

    • Single-Shot Protection for up to 180 minutes.

    • Superior Myocardial Protection.

    • Reduced Hospital Stay and Faster Recovery

      - Less intraoperative time compared to traditional repetitive cardioplegia.

      - Cost-effective when compared with blood cardioplegia.

    • Facilitates rapid perfusion and cooling of organs due to low viscosity.

    • Sustains energy supply

    • Exhibits strong antioxidant effects

    • Safe, Simple and Ready-to-use

    • Standardized formulation

    • Manufactured to GMP.

CUSTODIOL HTK Solution

Histidine-Tryptophan-Ketoglutarate Solution

Indicated for:

    • (MICS) Minimally Invasive Cardiac Surgery

    • Coronary Artery Bypass (CABG)

    • Paediatric Heart Surgery

    • Heart Transplantation

    • Standard preservation solution for abdominal organs in the Eurotransplant region

    • Preferred by leading transplant centres in North and South America, and increasingly in Asia and Africa

    • Suitable for multi-organ procurement (heart, liver, kidney, pancreas, composite tissue)

    • Reliable protection for organs, including those from non-heart beating donors

    • "Ready-to-use"

Storage condition: 2 -8°C

CUSTODIOL Production Overview

Proven Track Record of CUSTODIOL

Global Approval

Registered and approved for use in many countries worldwide.

Extensive Clinical Evidence

Over 1,000 scientific publications

Widespread Use

Used in over 3 million procedures worldwide.

History of CUSTODIOL

Dr. Franz Köhler, in collaboration with Prof. Bretschneider, developed the initial formulation of CUSTODIOL.  

Dr. Franz Josef Köhler

1909 - 1984

Prof. Hans-Jürgen Bretschneider

1922 - 1993

CUSTODIOL Digital Brochures

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Holistic support and dedicated training for our trusted partners.

    1. Preusse, C.J., Time to Reconsider the ‘Cardioplegia Paradigm’. Perfusionist, 2018. 42: p. 1-4.

    2. Albadrani, M., Histidine-tryptophan-ketoglutarate solution versus multidose cardioplegia for myocardial protection in cardiac surgeries: a systematic review and meta-analysis. J Cardiothorac Surg, 2022. 17(1): p. 133.

    3. Preusse, C.J., CUSTODIOL® Cardioplegia: A Single-Dose Hyperpolarizing Solution. J Extra Corpor Technol, 2016. 48: p. 15-20.

    4. Lück, S., lntraoperative Myokardprotektion mittels Bretschneider-Kardioplegie. Kardiotechnik, 2016. 04: p. 1-4.

    5. Doetsch, N., Habilitation – Systemische Auswirkungen Histidingepufferter Kardioplegischer Lösung HTK nach Bretschneider. 1993: Pabst Verlag.

    6. Gubernatis, G., et al., HTK-solution (Bretschneider) for human liver transplantation. First clinical experiences. Langenbecks Arch Chir, 1990. 375(2): p. 66-70.

    7. Garfinkel, L., R.A. Altschuld, and D. Garfinkel, Magnesium in cardiac energy metabolism. J Mol Cell Cardiol, 1986. 18(10): p. 1003-13.

    8. Braathen, B., et al., One single dose of histidine-tryptophan-ketoglutarate solution gives equally good myocardial protection in elective mitral valve surgery as repetitive cold blood cardioplegia: a prospective randomized study. J Thorac Cardiovasc Surg, 2011. 141(4): p. 995-1001.

    9. Arslan, A., et al., Low-dose histidine-tryptophan-ketoglutarate solution for myocardial protection. Transplant Proc, 2005. 37(7): p. 3219-22.

    10. Kammerer, I., et al., Myocardial Protection in Minimally Invasive Mitral Valve Surgery: Comparison of the Cold-Blood Cardioplegia of the Bretschneider Solution and the Warm-Blood Cardioplegia of the Calafiore Protocol. Archives of Clinical and Experimental Surgery (ACES), 2012. 1(1).

    11. Ali, I., et al., Efficacy of Histidine-Tryptophan-Ketoglutarate Solution Versus Blood Cardioplegia in Cardiac Surgical Procedures: A Randomized Controlled | Parallel Group Study. Heart Surg Forum, 2021. 24(1): p. E170-e176.

    12. Mercan, I., et al., Comparison between the Effects of Bretschneider's HTK Solution and Cold Blood Cardioplegia on Systemic Endothelial Functions in Patients who Undergo Coronary Artery Bypass Surgery: a Prospective Randomized and Controlled Trial. Braz J Cardiovasc Surg, 2020. 35(5): p. 634-643.

    13. Vivacqua, A., et al., Single-dose cardioplegia protects myocardium as well as traditional repetitive dosing: A noninferiority randomized study. J Thorac Cardiovasc Surg, 2020. 159(5): p. 1857-1863 e1.

    14. Giordano, R., et al., CUSTODIOL® Solution and Cold Blood Cardioplegia in Arterial Switch Operation: Retrospective Analysis in a Single Center. Thorac Cardiovasc Surg, 2016. 64(1): p. 53-8.

    15. Hummel, B.W., et al., Myocardial Protection and Financial Considerations of CUSTODIOL® Cardioplegia in Minimally Invasive and Open Valve Surgery. Innovations (Phila), 2016. 11(6): p. 420-424.

    16. Wilson, C.H., et al., Comparison of HTK and hypertonic citrate to intraarterial cooling in human non-heart-beating kidney donors. Transplant Proc, 2007. 39(2): p. 351-2.

    17. Tangvoraphonkchai, K. and A. Davenport, Magnesium and Cardiovascular Disease. Adv Chronic Kidney Dis, 2018. 25(3): p. 251-260.

    18. Powell, W.J., Jr., et al., The protective effect of hyperosmotic mannitol in myocardial ischemia and necrosis. Circulation, 1976. 54(4): p. 603-15.

    19. Waskowski, J., et al., Mannitol for the Prevention of Peri-Operative Acute Kidney Injury: A Systematic Review. Eur J Vasc Endovasc Surg, 2019. 58(1): p. 130-140.

    20. Holper, K., et al., Technical refinements in myocardial protection: infants--adults. Thorac Cardiovasc Surg, 1998. 46 Suppl 2: p. 292-5; discussion 296-7.