Increased Use of Donors After Cardiac Death (DCD) in Pancreas Transplantation: A Safe and Effective Way to Increase a Single Center Program Activity
Multi-Organ Transplant, University Health Network, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: C191
Keywords: Pancreas
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 SRTR database shows that DCD donors are rarely used for pancreas transplantation in the USA (< 3% in 2010 -2012). This low rate likely reflects the perception that DCD pancreases have a higher risk of complications, dysfunction, and failure despite single-center reports showing equivalent outcomes as compared with donation-after-brain death (DBD) pancreases. To address this issue, we reviewed 120 consecutive pancreas transplants (SPK, 78; PAK, 42) performed at our center between January 2011 and July 2014. RESULTS: We performed 13 DCD transplants (9 SPK and 4 PAK) over this time period. The number of DCD transplants increased from 1 (4% of total activity) in 2011, to 3 (8%) in 2012 and 2013, and to 6 (23%) in the first 6 months of 2014. Donor demographics were similar in DCD and DBD recipients with respect to age (27±10 yrs vs. 24±7 yrs; p=0.49), kidney cold ischemia time (CIT; 490±110 min vs. 442±68 min; p=0.20) and warm ischemia time (WIT; 32±11 min vs. 34±7 min; p=0.34), and pancreas CIT (588±108 min vs. 578±74 min; p=0.83) and WIT (30±7 min vs. 30±6 min; p=0.87). DCD recipients were predominantly male 93% vs. 63% (p=0.03), whereas there was no difference in recipient age (45±9 yrs vs. 42±9 yrs, p=0.28) and transplant wait-times (50±22 vs. 49±38 mo., p=0.35) in the DCD and DBD groups, respectively. Delayed kidney graft function requiring at least one dialysis session after transplantation occurred in 2 (22%) DCD recipients and 2 (3%) DBD recipients (p=0.05). All DCD kidneys and all but one DCD pancreases, which was lost from medication noncompliance, are functioning currently. No difference in pancreas and/or kidney rejection was observed. Pancreas function assessed by HbA1c values was similar in DCD and DBD recipients at 6-months (5.3% and 5.5%) and at 1-year (5.2% and 5.5%). Creatinine levels were also similar in DCD and DBD recipients at 3-months (131+17 umol/L and 121+17 umol/L), 6-months (136+25 and 126+16), and 1-year (131+16 and 131+17). One-year K-M survival for DCD and DBD pancreases and kidneys was 92% and 90% (p=0.64) and 99% and 100%(p=0.49), respectively. CONCLUSION: DCD pancreases provide a safe and effective way to increase the number of pancreases available for transplantation
To cite this abstract in AMA style:
Marquez M, Sapisochin G, Laurence J, Barbas A, Dib M, Norgate A, Selzner M, Greig P, McGilvray I, Cattral M. Increased Use of Donors After Cardiac Death (DCD) in Pancreas Transplantation: A Safe and Effective Way to Increase a Single Center Program Activity [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/increased-use-of-donors-after-cardiac-death-dcd-in-pancreas-transplantation-a-safe-and-effective-way-to-increase-a-single-center-program-activity/. Accessed May 17, 2025.« Back to 2015 American Transplant Congress