Introduction:

Alcohol (EtOH) abuse can damage the pancreas, but outcomes of pancreas transplantation from donors with a high EtOH intake are poorly defined. The aim of this study was to determine if donor EtOH intake influenced pancreas allograft survival in SPK transplantation.

Methods: UK registry data was used to assess graft survival in SPK recipients between 2006-2012. Core donor data forms were analysed and (where quantified) EtOH intake was calculated. Variables were stratified by donor EtOH intake: group I – quantified high recent EtOH intake (>21 units/week in males; >14 units/week in females) or a history of EtOH abuse; group II – no (or unknown) history of EtOH abuse and a recent intake less than the above thresholds. Continuous variables are expressed as median (IQR).

Results: Seven hundred and seventy SPK transplants were performed (group I, n=120; group II, n=650). In group I, 51 donors had high quantified recent EtOH intake only, 34 had a history of EtOH abuse but recent intake wasn't documented, 33 had a history of abuse with a high recent intake documented, and 2 had a history of abuse with a recent intake less than threshold. As expected, quantified current EtOH intake was higher in group I than group II (39 (24-59) vs 10 (5-13) units/week; p<0.001). Donors in group I were more likely to be male (61% vs 49%; p=0.02), and older (42 (32-48) vs 38 (26-46) years; p<0.001); however, there were no differences in the proportions of DCD donors, median donor BMI, or median recipient age between the two groups. Cold ischaemic time was shorter in group I (660 (539-839) vs 733 (613-900) mins; p<0.001). There was no difference in subsequent graft survival between groups I and II (5yr graft survival 74% v 76% respectively, p=0.95, log rank test), or between group II and the sub-group of 33 donors with both a history of EtOH abuse and a high recent intake (5yr graft survival 76% vs 57% respectively, p=0.17, log rank test).

Conclusions: Pancreas donors with past EtOH abuse or recent high intake are common, and graft outcomes appear to be as good as those who have received a pancreas from donors with normal EtOH intake/no history of EtOH abuse. This analysis suggests that excessive donor EtOH intake, by itself, should not exclude pancreas utilisation.

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