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Pancreas Transplantation With Grafts From Donors Deceased After Circulatory Death: 5 Years Single-Center Experience

Kopp, W.H. MD1; Lam, H.D. MD1; Schaapherder, A.F.M. MD, PhD1; Huurman, V.A.L. MD, PhD1; van der Boog, P.J.M. MD, PhD2; de Koning, E.J.P. MD, PhD2; de Fijter, J.W. MD, PhD2; Baranski, AG. MD1; Braat, A.E. MD, PhD1

doi: 10.1097/TP.0000000000001940
Original Clinical Science—General

Background Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented.

Methods A retrospective, single-center analysis (2011-2015) was performed to compare the results of donation after brain death (DBD) to DCD pancreas transplantation.

Results During the study period, 104 pancreas transplantations (83 from DBD and 21 from DCD) were performed. Median Pancreas Donor Risk Index (PDRI) was 1.47, (DBD, 1.61 vs DCD, 1.35; P = 0.144). Without the factor DCD, PDRI from DCD donors was significantly lower (DBD, 1.61 vs DCD, 0.97; P < 0.001). Donor age was the only donor-related risk factor associated with pancreas graft survival (Hazard ratio, 1.06; P = 0.037). Postoperative bleeding and kidney delayed graft function occurred more frequently in recipients from DCD (P = 0.006). However, DCD pancreata had a lower incidence of thrombosis. Kidney and pancreas graft survival were equally good in both groups.

Conclusions Pancreas transplantation from DCD donors yields comparable results to DBD donors when PDRI of DCD is relatively low. Most DCD donors are younger donors with trauma as cause of death. These DCD pancreas grafts may be a better option to cope with increasing organ shortages than exploring the limits with older (and higher PDRI) DBD donors.

Pancreas transplantation from DCD donors yields comparable results to DBD donors when pancreas donor risk index of DCD are relatively low and these DCD pancreas grafts may be a better option than exploring the limits with older DBD donors.

1 Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.

2 Section of Nephrology, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.

Received 23 May 2017. Revision received 15 August 2017.

Accepted 18 August 2017.

The authors declare no funding or conflicts of interest.

W.H.K., H.D.L., A.F.S., and A.E.B. designed the study. W.H.K., P.J.M.B., E.J.P.K., and A.E.B. wrote the article. All authors participated in the collection of the data and critically revised the article.

Correspondence: Andries E. Braat, MD, PhD, Division of Transplantation, Department of Surgery, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. (a.e.braat@lumc.nl).

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