A data review of all pancreas transplants since 2003 (n=606) at our institution revealed 41 recipients of a non-identical ABO donor pancreas. They were matched for age, race, gender, year of transplant and type of transplant. The two groups were compared for incidence of acute cellular rejection; length of hospital stay after transplant; number of readmissions within 3 months of transplant and transfusion requirements in the first year after transplant. Six of 41 patients (14%) in the study group had hemolysis. All of these were O into A group transplants. The median 1 year graft survival by Kaplan-Meier was 100% in the study group and 88% in the control group.

Discussion: There is no data on pancreas transplant using non identical but compatible ABO donors. Allo-immune mediated hemolysis is caused by donor derived lymphocytes producing antibodies against recipient blood group antigens. The risk for developing hemolysis is greatest for group O into A transplant. Antibodies against minor blood group antigens also cause hemolysis. Clinically significant hemolysis requiring blood transfusions have been reported to be about 70%, 40% and 17% in ABO compatible heart-lung, liver and kidney transplants respectively. In our series 14% of pancreas transplants had hemolysis. The hemolysis is usually transient occurring within the first 3 months after transplant and can be treated with monitoring and transfusion of donor blood type PRBCs. Rarely additional immunosuppression or plasmapheresis may be required. ABO compatible pancreas transplants have similar 1 year graft survival as ABO identical transplants.

CITATION INFORMATION: Nagaraju S., Mangus R., Fridell J. Outcomes of ABO Non-Identical Pancreas Transplant Am J Transplant. 2017;17 (suppl 3).

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