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Pancreas Transplantation from Pediatric Donors: A UNOS Registry Analysis.

M. Spaggiari, I. Tzvetanov, H. Jeon, E. Benedetti, J. Oberholzer.

Division of Transplantation, University of Illinois at Chicago, Chicago.

Meeting: 2016 American Transplant Congress

Abstract number: 25

Keywords: Donors, Graft function, marginal, Pancreas, Pediatric

Session Information

Date: Sunday, June 12, 2016

Session Name: Concurrent Session: Donor Management: All Organs

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:30pm-3:42pm

Location: Room 306

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Introduction: Major concerns about the utilization of pediatric pancreata are the cumulative islet mass and the increased technical complexity. The primary aim of this study was to investigate the non-inferiority of pediatric donor when compared to adult donor.

Materials and Methods: Analysis was performed from the OPTN database. The study subject was pancreas transplantation from pediatric donor (≤18 years) in the era 2000 to 2015.

Results: In the era selected, 18430 pancreas transplants were performed from 4915 (27.7%) pediatric donors. Differences between the pediatric and the adults donor cohort included: donor BMI (22.2 vs 24.2 p<0.000) and weight (65.0Kg vs. 73.3Kg p<0.000); Amylase value at procurement (72 u/L vs. 63 u/L p<0.000), donor Insulin requirement (1888 (57.8%) vs 5653 (61.2%) p:0.001); recipient BMI (24.5 vs 24.7 p:0.005) and weight (71.4Kg vs 72.1 p:0.004). Results of patient and graft survival by donor type, age groups, weight groups and recipient donor weight ratio are summarized in

 

 

3 ys survival

%

5 ys survival

%

10 ys survival

%

P value

 

 

Patient

Graft

Patient

Graft

Patient

Graft

Patient

 

Donor Type

 

 

 

 

 

 

 

0.001

<0.001

 

Pediatric

93

78

88

71

70

54

 

Adult

92

75

86

67

68

51

Donor Age (ys)

 

 

 

 

 

 

 

NS

 

 

≤ 6

94

79

87

69

65

50

 

 

7-12

92

75

87

65

70

49

 

 

13-18

93

78

88

72

71

55

 

Donor Weight (Kg)

 

 

 

 

 

 

 

 

 

<30

92

75

84

64

60

44

0.034

 

 

30-95

93

78

88

71

71

54

 

 

>95

93

80

88

77

79

68

 

Rec/Don Weight Ratio

 

 

 

 

 

 

 

 

 

≤1

92

77

86

70

70

55

NS

 

The risk of graft loss was associated with younger age (HR 0.98 95% CI 0.97-0.99 p<0.001) and longer length of stay (HR 1 CI 1.00-1.00 p: 0.001).

Conclusion: Pancreata from pediatric donors offers not inferior outcome of their adult counterpart and should be used without hesitation. However the graft (and patient) survival standardized by weight groups clearly shows at 10 years that the cumulative islet mass matters. Keeping a recipient/donor weight ratio <2 could be an easy strategy to optimize the long term results.

CITATION INFORMATION: Spaggiari M, Tzvetanov I, Jeon H, Benedetti E, Oberholzer J. Pancreas Transplantation from Pediatric Donors: A UNOS Registry Analysis. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Spaggiari M, Tzvetanov I, Jeon H, Benedetti E, Oberholzer J. Pancreas Transplantation from Pediatric Donors: A UNOS Registry Analysis. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/pancreas-transplantation-from-pediatric-donors-a-unos-registry-analysis/. Accessed March 6, 2021.

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