Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
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.
|Outcomes||ABO identical||ABO non identical||p value|
|Lenght of hospital stay (days)||6.5||8||0.69|
|Readmission within 3 months||40%||55%||0.34|
|Mean packed red cell transfusions|
|1 year graft survival||88%||100%||0.05|
|median survival by Kaplan Meier (months)||110||119||0.27|
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).
To cite this abstract in AMA style:Nagaraju S, Mangus R, Fridell J. Outcomes of ABO Non-Identical Pancreas Transplant [abstract]. https://atcmeetingabstracts.com/abstract/outcomes-of-abo-non-identical-pancreas-transplant/. Accessed April 8, 2020.
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