Review of UK-Wide Practice of Pancreas Transplantation: Donor Selection, Back-Bench Preparation & Implantation Technique.
1Multi Organ Transplant Unit, London Health Sciences Centre, London, ON, Canada
2Kidney Pancreas Transplant Unit, Manchester Royal Infirmary, Manchester, United Kingdom
3Multi Organ Transplant Unit, Toronto General Hospital, Toronto, Canada
4Multi Organ Transplant Unit, Oxford Transplant Centre, Oxford, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: B289
Keywords: Donation, Pancreas transplantation
Session Information
Session Name: Poster Session B: Surgical Issues (Minimally Invasive/Open): All Organs
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Experience of Centers for simultaneous pancreas and kidney (SPK) transplantation is not uniform. Variability in operative steps may explain inconsistent surgical outcomes.
Methods: A web survey was sent to all Pancreas transplant surgeons in the United Kingdom. The survey assessed current trends in 1) Donor Selection 2) Back-Bench Preparation 3) Implantation Technique of SPK transplant. It also addressed Surgeon demographics & training, immunosuppression and organ offer acceptance approaches.
Results: All 8 transplant centres across UK performing pancreas transplant responded. 28/31 (90%) surgeons completed the survey. 77% had >5 years transplant experience. 54% surgeons did not have a uniform back table benching and implantation technique at their centre. 52% and 42% surgeons were comfortable in accepting a pancreas if predicted cold ischemia time was <12 hr for DBD & DCD transplants respectively. 26% respondents would accept an offer from 65-year-old donor and 61% preferred donors <60 years. 52% surgeons will not consider an offer with donor hyperamylasemia. 42% would accept donor with BMI16-20; 34% will accept donor BMI 35. 26% surgeons would accept a downtime > 60 minutes. 26% & 30% surgeons used harmonic scalpel and ligasure respectively for back benching. 81% bury the duodenal staple line. 88% surgeons used midline incision; 92% placed pancreas intra-peritoneally; 31% placed kidney extraperitoneally. 85% used IVC for portal drainage, 81% used CIA for arterial inflow. 42% and 46% preferred jejunum and ileum for exocrine drainage respectively. 85% surgeons placed kidney contralateral to the pancreas.
Conclusion: The surgical practice in SPK transplant varies across UK. A consensus surgical guideline would streamline the variability for optimal outcomes.
CITATION INFORMATION: Sharma H, Bhutani S, Vandellen D, Campbell T, Pararajasingham R, Forgacs B, Tavakoli A, Friend P, Augustine T, Dhanda R. Review of UK-Wide Practice of Pancreas Transplantation: Donor Selection, Back-Bench Preparation & Implantation Technique. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sharma H, Bhutani S, Vandellen D, Campbell T, Pararajasingham R, Forgacs B, Tavakoli A, Friend P, Augustine T, Dhanda R. Review of UK-Wide Practice of Pancreas Transplantation: Donor Selection, Back-Bench Preparation & Implantation Technique. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/review-of-uk-wide-practice-of-pancreas-transplantation-donor-selection-back-bench-preparation-implantation-technique/. Accessed May 11, 2025.« Back to 2017 American Transplant Congress