2011 - IPITA - Prague


Parallel session 1 – Open oral presentations Topic: Pancreas transplantation: Results and surgical aspects

1.5 - Equivalent graft outcomes between donation after brain death (DBD) and donation after cardiac death (DCD) pancreas transplant

Presenter: T., Jie, Tucson, USA
Authors: T. Jie, A. Gruessner, C. Desai, K. Khan, H. Rilo, R. Gruessner



Equivalent graft outcomes between donation after brain death (DBD) and donation after cardiac death (DCD) pancreas transplant

T. Jie, A. Gruessner, C. Desai, K. Khan, H. Rilo, R. Gruessner
University of Arizona, Surgery, Tucson, USA

DCD pancreas allograft was underutilized because the concerns of technical complications, detrimental effects of prolonged warm ischemic injury, increased risks of developing graft pancreatitis and poor long-term graft outcomes. A retrospective database (IPTR) review was performed in three categories of pancreas transplant: pancreas transplant alone (PTA), pancreas after kidney transplant (PAK), or simultaneous pancreas and kidney transplant (SPK) between 2000 and 2009. 1.73% (n=225) of the pancreas grafts were from DCD among 12,983 pancreas transplant performed. The DCD graft utilization increased from 0.38% in 2000 to 3.43% in 2009. The categories of pancreas transplants from DBD and DCD were shown. The recipient age, gender, BMI, wait time, PRA, HLA mismatch; and donor age, gender, causes of death, BMI, and cold ischemic time were found not to be significantly different between DBD and DCD pancreas transplants. In addition, we compared centers that performed more than 20 pancreas transplants per year for last 5 years (high volume) to others. High volume centers were found to have 2.2-folds increased likelihood of utilization DCD pancreas (odds ratio 2.216, 95% confidence limits between 1.641 and 2.991). Furthermore, high volume centers also performed proportionally more primary PTA (66%), vs. PAK (35%) and SPK (38%) when compared to other centers (p-value 0.0001). Importantly, the pancreas graft outcomes were similar between DBD and DCD pancreas transplant in all three categories (table 2). High volume pancreas transplant centers performed more primary PTA and had higher DCD utilization. With comparable long-term pancreas graft outcomes, pancreas transplant from DCD graft should be seriously considered.

Category

DCD 3-yr graft survival

BDD 3-yr graft survival

p-value

PTA

50.87%

59.01%

0.318

PAK

60.16%

65.26%

0.833

SPK

80.98%

77.61%

0.166


You must be logged in to view recordings

Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Our Corporate Sponsors

TTS gratefully acknowledges the Corporate Partners whose generous support makes the work of the Society possible:

  • astellas
  • roche
  • sanofi