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Pancreas Transplantation From Pediatric Donors: A United Network for Organ Sharing Registry Analysis

Spaggiari, Mario MD1; Bissing, Martha BS1; Campara, Maya PharmD2; Yeh, Chun-Chieh MD3; Tzvetanov, Ivo MD1; Jeon, Hoonbae MD1; Benedetti, Enrico MD1

doi: 10.1097/TP.0000000000001736
Original Clinical Science-General

Background: Pancreas grafts from pediatric donors are still considered “not ideal.” Perceived concerns are related to low islet mass and potential for graft thrombosis.

Methods: The study evaluated all pancreas transplants from January 2000 to May 2015 using the Organ Procurement and Transplant Network database. Comparative analysis of recipient and graft survival was performed between pediatric (≤18 years) and adult donors. In the pediatric group, the outcomes were stratified based on donor age (≤6, 7-12, and 13-18 years) and weight (<30, 30-95, and >95 kg).

Results: In the selected era, 18 430 pancreas transplants were performed from 4915 pediatric donors (27%). Short-term graft and patient survivals were comparable between pediatric and adult donors. Ten-year patient and graft survivals were higher in the pediatric donor group: (70% and 54% vs 68% and 51%, P = 0.001). However, very-low-weight pediatric donors (<30 kg) resulted in worse graft survival in the long term (44% at 10 years, P = 0.006).

Conclusions: Pediatric donor pancreas transplants had comparable patient and graft survival to the adult donor transplants. However, the islet mass of very small donors could influence long-term graft survival if the weights of donors and recipients are not properly matched. Usage of “very small” pediatric donors was not associated with higher incidence of technical complications or early graft loss.

Pediatric donor pancreas transplants have comparable patient and graft survival to the adult donor transplants and utilization of very small pediatric donors are not associated with higher incidence of technical complications or early graft loss.

1 Department of Surgery, University of Illinois, Chicago, IL.

2 Department of Pharmacy Practice, University of Illinois, Chicago, IL.

3 Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.

Received 24 October 2016. Revision received 24 February 2017.

Accepted 3 March 2017.

The present study is based on OPTN data as of September 25, 2015. This work was supported in part by Health Resources and Services Administration (contract 234-2005-370011C). The content is the responsibility of the authors alone and does not necessarily reflect the views of policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organization imply endorsement by the US Government.

The authors declare no conflicts of interest.

M.S. participated in study design, statistical analysis, and writing. M.B. participated in article writing and critical review. M.C. participated in article writing and critical review. C-C.Y. participated in data analysis and critical review. I.T. participated in critical review and study design. H.J. participated in critical review and study design. E.B. participated in critical review and study design.

Correspondence: Mario Spaggiari, MD, Department of Surgery, University of Illinois, Suite 522, Clinical Science Bldg, 840 South Wood St, Chicago, IL 60612. (mspaggia@uic.edu).

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