Effect of Donor Age On Pancreas Transplantation Outcome

A. Rathnasamy Muthusamy,¹ G. Vrakas,¹ S. Mittal,¹ S. Reddy,¹ I. Quiroga,¹ J. Gilbert,¹ R. Ploeg,² E. Sharples,¹ S. Sinha,¹ A. Vaidya,¹ P. Friend.²

¹Transplant Surgery, Churchill Hospital, Oxford, United Kingdom
²Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom.

Meeting: 2015 American Transplant Congress

Abstract number: C196

Keywords: Cadaveric organs, Donors, marginal, non-heart-beating, Pancreas transplantation

Session Information

Session Name: Poster Session C: More Controversies in Pancreas Transplantation

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

The global increase in the average donor age over the last decade has resulted in widespread acceptance of pancreases from older donors for transplantation. This abstract aims to review the effect of this cohort on pancreas graft and patient survival.

Methods: Prospectively maintained database of pancreases transplanted from 2004-2014 at a single centre was analysed, comparing pancreas & kidney, graft & patient survival, delayed graft function (DGF) and non-function (PNF) between all (DCD and DBD) donors aged >50 years (ED) and standard criteria donors (SD).

Results: 684 transplants occurred from 562 SD and 122 ED including 89 SD-DCD and 4 ED-DCD with median follow up of 32 months (SD) and 28 months (ED). There were 422 SPK, 55 PAK and 85 PTA from SD; 105 SPK, 1 PAK and 16 PTA from ED. ED had a median age of 55 yrs (51-67). Recipients of ED grafts were older (47 vs. 42, p<0.0001) reflecting the intention to match donor and recipient age. Actuarial pancreas (90% SD vs. 87% ED, p=0.9), kidney (87% SD vs. 88% ED, p=0.9) and patient survival (90% SD vs. 87% ED, p=0.1) was similar. Overall DGF of the pancreas (9% ED vs. 4% SD, p=NS) and kidney (27% ED vs. 16% SD, p=0.06) was similar, as was PNF rate for pancreas (4% ED vs. 1% SD, p= NS) and kidney (4% ED vs. 1% SD). The Isolated pancreas transplants (PAK & PTA) had similar pancreas graft outcomes (76% ED vs. 71% SD, p=0.5). However, when the DCD grafts were excluded, kidney DGF rates became significantly higher in ED (26% vs. 10%, p=0.0006) whereas the pancreas DGF rate remained similar (3% ED vs. 2% SD).

Conclusion: Utilising older donors for pancreas transplantation appears to be safe, providing the increased risk of delayed graft function is duly considered in the risk-benefit analysis. Older donors for isolated pancreas transplant merit careful consideration.

To cite this abstract in AMA style:

Muthusamy ARathnasamy, Vrakas G, Mittal S, Reddy S, Quiroga I, Gilbert J, Ploeg R, Sharples E, Sinha S, Vaidya A, Friend P. Effect of Donor Age On Pancreas Transplantation Outcome [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-donor-age-on-pancreas-transplantation-outcome/. Accessed November 21, 2024.

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