Post-Donation Outcomes in 46 Live Pancreas Donors
Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN.
Meeting: 2015 American Transplant Congress
Abstract number: 11
Keywords: Donation, Outcome, Pancreas transplantation
Session Information
Session Name: Concurrent Session: Controversies in Pancreas Transplantation
Session Type: Concurrent Session
Date: Sunday, May 3, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 3:15pm-3:27pm
Location: Room 122-AB
Background: Live donor segmental pancreas transplants have been performed selectively to increase the pool of donors, minimize cold ischemia time, and to avoid brain death. Post-donation outcomes among live pancreas donors have not been well studied.
Methods: Between 1/1/1994 and 5/1/2013, 37 LR and 9 LUR partial pancreas transplants (40 SPK, 2 PAK, 4 PA) (7 laparoscopic, 39 open) were performed with median follow-up of 12 years (0-18 years). Post-donation complications, pre- and post-donation BMI, glycemic control, HTN, hyperlipidemia and cardiovascular disease were studied. Pancreas graft survival and causes of graft loss are reported.
Average donor age was 42.8 (+/- 9.7) years old (39% male, 91% Caucasian). Eight donors were lost to follow-up (>4 yrs); 38 donors were alive at the time of the last follow-up.
Results: Pre- and post-donation glucoses and BMIs were 90+/-19 mg/dL and 25+/-3.7 kg/m²; and 110+/-36 mg/dL and 25.7+/-3.2 kg/m². Post-donation outcomes are shown in Table 1.
Number of Events | ||
Intraoperative: | ||
Splenectomy | 5 (11%) | |
Transfusion (1-5 units) | 4 (9%) | |
Transfusion (6-10 units) | 1 (2%) | |
Postoperative: | ||
Pseudocyst | 6 (13%) | |
Pancreatitis | 2 (4%) | |
Splenic infarct (requiring splenectomy) | 4 (9%) | |
New Diagnosis: | ||
Hyperglycemia requiring oral hypoglycemics/dietary control | 7 (15%) | |
Hyperglycemia requiring insulin | 5 (11%) | |
Hyperlipidemia | 13 (28%) | |
HTN | 10 (22%) | |
Cardiovascular disease | 6 (13%) |
Mean graft survival was 8.3 (+/-5.4) years; death censored graft survival was 91%, 73%, 50% at 1, 5 10 years post-transplant. At the time of last follow-up, 24 (55%) grafts failed (Table 2).
Chronic Rejection | 46% (12) |
Unknown | 23% (6) |
Graft Thrombosis | 12% (3) |
Graft Malignancy | 4% (1) |
Pancreatitis | 4% (1) |
Acute Rejection | 4% (1) |
Conclusions: Segmental live pancreas donation is associated with significant surgical complications including splenectomy, pseudocyst formation and metabolic complications including post-donation hyperglycemia. Careful surgical and metabolic screening could potentially improve these outcomes. Recipient outcomes however are comparable to historical DD outcomes despite a higher graft thrombosis rate.
To cite this abstract in AMA style:
Kirchner V, Sutherland D, Dunn T, Finger E, Pruett T, Kandaswamy R. Post-Donation Outcomes in 46 Live Pancreas Donors [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/post-donation-outcomes-in-46-live-pancreas-donors/. Accessed October 3, 2024.« Back to 2015 American Transplant Congress