Pancreas (Px) Transplantation (Tx) Following Donation after Cardiac Death (DCD): 5 Year Outcomes – Matched Pair Analysis
Surgery, University of Minnesota, Minneapolis, MN
Meeting: 2013 American Transplant Congress
Abstract number: C1393
DCD Px donors are underutilized accounting for <3% of PxTx in the US. We hypothesize that outcomes of Px Tx from DCD are comparable to brain dead (DBD) donors. To verify this, we compared our DCD recipients with a case-matched group of DBD recipients.
Methods: Between August 2004 and August 2009, 29 DCD grafts (42%SPK, 38%PTA,8%PAK) and 284 DBD grafts were transplanted. Our DCD donor group median age was 24.8(range 15 to 48.6), with a warm ischemia time of < 30 minutes.
| Donors | DCD (26) | DBD (52) | p-value |
| Cause of Death | 0.718 | ||
| CV/Stroke | 4(15%) | 10(19%) | |
| Trauma | 18(69%) | 37(71%) | |
| Other | 4(15%) | 5(10%) | |
| Gender(Female) | 8(31%) | 18(35%) | 0.734 |
| Donor Age Group | 0.771 | ||
| 18-34y | 23(88%) | 43(83%) | |
| 35-44y | 1(4%) | 6(12%) | |
| 45-54y | 2(8%) | 3(6%) | |
| Race(White) | 24(92%) | 44(90%) | 0.761 |
| Blood Type | 0.141 | ||
| Type A | 8(31%) | 14(27%) | |
| Type B | 1(4%) | 9(17%) | |
| Type AB | 1(4%) | 0(0%) | |
| Type O | 16(62%) | 29(56%) | |
| BMI | 0.515 | ||
| <18.5 | 1(4%) | 1(%) | |
| 18.5-24.9 | 13(57%) | 29(60%) | |
| 25.0-29.9 | 9(39%) | 13(27%) | |
| >30.0 | 0(0%) | 5(10%) | |
| Pre Tx Creatinine (mean,SEM) | 0.9 +/- 0.1 | 1.1 +/- 0.1 | 0.003 |
| Pre Tx Amylase(mean,SEM) | 117.4 +/- 27.1 | 266.9 +/- 105.2 | 0.178 |
| Pre Tx Lipase(mean,SEM) | 45.2 +/- 28.6 | 58.0 +/- 2.0 | 0.678 |
We matched 26 DCD with 52 DBD recipients (1:2 ratio) on the basis of identified variables (donor age, CIT, cause of death, type of transplant, no of transplant. We compared patient and graft survival (overall, death-censored graft survival, acute rejection (AR) and technical failure (TF) rates.
Results: Patient one and five-year survival for the two groups were similar( DCD: 81.8% – 81.8% vs DBD: 91% – 73%, p>0.05). Px Graft one and five-year survival for the two groups were similar (DCD: 73.08% – 64.90% vs DBD: 71.15% – 58.89%, p>0.05). Death -censored Px Graft one and five-year survival for the two groups were similar (DCD: 84.62%-75.15% vs DBD: 76.31% – 67.68%, p>0.05). AR Free Px Graft one and five-year survival for the two groups were similar (DCD: 84.62%-68.77% vs DBD: 78.85%-72.51%, p>0.05). TF rate (within 90 days) was also similar (DCD: 7.69% vs DBD: 7.69%, p>0.05). We repeated the analysis using the whole DBD group as control without matching and did not find any significant differences in the outcome measures shown above (data not shown).
Conclusions: Px Tx from carefully selected DCD donors can be safely performed with no adverse effect on primary outcomes. Careful donor/recipient selection and minimization of ischemia time are critical.
To cite this abstract in AMA style:
Chandolias N, Lohlun J, Radosevich D, Finger E, Dunn T, Kandaswamy R. Pancreas (Px) Transplantation (Tx) Following Donation after Cardiac Death (DCD): 5 Year Outcomes – Matched Pair Analysis [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/pancreas-px-transplantation-tx-following-donation-after-cardiac-death-dcd-5-year-outcomes-matched-pair-analysis/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress