The Association of Donor Vasoactive Drugs with Pancreas Transplant Graft Survival.
1Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, United Kingdom
2Department of Renal and Pancreas Transplantation, Central Manchester University Hospitals, Manchester, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: C232
Keywords: Donation, Pancreas, Pancreas transplantation, Prediction models
Session Information
Session Name: Poster Session C: Pancreas and Islet (Auto and Allo) Transplantation
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Introduction: Vasoactive drugs (VaD) are commonly used to correct abnormal haemodynamics of organ donors in Intensive Care Units (ICU). VaDs can differentially affect insulin secretion positively (dobutamine) or negatively (noradrenaline). Therefore, we hypothesised that some VaDs might induce beta-cell stress/death and be associated with adverse pancreas transplant outcomes. We aimed to assess relationships of VaD use to pancreas transplant graft survival.
Methods: UK Transplant registry data (2004-2016) were used to assess associations between VaD use and covariate-adjusted pancreas graft survival (median follow-up: 3 years).
Results: In 1944 pancreas transplants, VaDs were used in the following numbers (proportions) of donors: dobutamine 70 (3.5%), dopamine 77 (4.0%), adrenaline 145 (7.5%), noradrenaline 1402 (72%) and vasopressin 1091 (56.1%). In donor variable-adjusted models, noradrenaline use (vs. non-use) was associated with better graft survival (HR (95%CI): 1.28 (1.02-1.62) p=0.033) and this relationship remained significant after further adjustment for cold ischaemic time (HR: 1.31 (1.04-1.65), p= 0.021) and recipient variables (HR: 1.34 (1.03-1.75), p= 0.032). In donor variable-adjusted models, dobutamine use (vs. non-use) was associated with significantly poorer graft survival (HR: 0.58 (0.39-0.90) p=0.01) but this relationship became non-significant after further adjustment for cold ischaemic time and recipient variable. Use of adrenaline, dopamine and vasopressin were not related to graft survival. Concomitant insulin use with VaDs was similar.
Discussion: Noradrenaline use was associated with better graft survival in models adjusting for donor and recipient variables and this may be related to inhibition of pancreatic insulin secretion (initiating pancreatic beta-cell 'rest'). Further research is establish whether relationships are causal before any recommendation of change in practice can be made.
CITATION INFORMATION: Shapey I, Yianoullou P, Summers A, Augustine T, Rutter M, van Dellen D. The Association of Donor Vasoactive Drugs with Pancreas Transplant Graft Survival. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Shapey I, Yianoullou P, Summers A, Augustine T, Rutter M, Dellen Dvan. The Association of Donor Vasoactive Drugs with Pancreas Transplant Graft Survival. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-association-of-donor-vasoactive-drugs-with-pancreas-transplant-graft-survival/. Accessed May 25, 2025.« Back to 2017 American Transplant Congress