Pancreata donated after circulatory death may expand organ pool

Reuters Health Information: Pancreata donated after circulatory death may expand organ pool

Pancreata donated after circulatory death may expand organ pool

Last Updated: 2017-10-09

By Reuters Staff

NEW YORK (Reuters Health) - Pancreas transplant outcomes with organs donated after circulatory death (DCD) are similar to outcomes with organs donated after brain death (DBD), as long as the donor risk index is relatively low, according to findings from a small study.

"A pancreas graft from a young, lean DCD donor after trauma with short cold ischemia time may in fact yield better results than pancreas grafts from older DBD donors," Dr. Andries Braat, of Leiden University Medical Center in the Netherlands, and colleagues write in their September 6 online report in Transplantation.

The number of suitable DBD organs has not met the demand for pancreata. Given that DCD pancreatic grafts have been shown to be suitable for transplantation, the researchers decided to explore whether DCD donors might be a promising additional organ source.

They retrospectively analyzed data from 104 consecutive pancreas transplants performed at their center from 2011 through 2015, comprising 83 from DBD donors and 21 from DCD donors.

The median pancreas donor risk index (PDRI) was 1.47, with a nonsignificant difference between DBD (1.61) and DCD (1.25) donors. When the investigators removed DCD itself as a risk factor, however, the median PDRI for DCD donors was 0.97, significantly lower than the 1.61 for DBD donors.

Donor age was the only donor-related risk factor to be associated with graft survival.

Delayed kidney-graft function and postoperative bleeding occurred more often with DCD than DBD organs, but DCD pancreata were less likely to develop thrombosis.

Patient and graft survival were similar between transplants from DBD donors and those from DCD donors at 90 days, one year, and two years.

"We advocate that DCD pancreata, especially those with lower PDRI (younger donors and trauma as cause of death) should be considered for transplantation," the researchers write. "Although DCD recipients have more postoperative bleeding and kidney delayed graft function, pancreas and kidney graft survival are at least equal to that of DBD recipients. Hopefully, these results will convince other transplant centers to utilize pancreata from DCD donors."

Dr. Braat was not available for an interview by press time.

SOURCE: http://bit.ly/2y57aM5

Transplantation 2017.

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