Are the outcomes of Japanese pancreas transplantation utilizing extended‐criteria donors acceptable? A propensity score matching analysis for donors <50 or ≥50 years old

Abstract

Summary In Japan, about 30% of pancreatic transplant donors are ≥50 years old, making them “extended‐criteria donors (ECDs).” We analyzed 361 cases of transplantation involving donors from the Japanese pancreas transplantation registry to evaluate the acceptability of ECDs. The patient survival rates at 1, 5, and 10 years after transplantation were 96.6%, 94.9%, and 88.3%, respectively. The survival rates of pancreas and kidney grafts at 1, 5, and 10 years were 85.3%, 74.8%, and 70.6%, and 94.2%, 90.9%, and 80.9%, respectively. Multivariate analysis revealed that no particular donor factors significantly influenced the pancreatic graft survival. Patients were divided into 2 groups: donors ≥50 years old (older group) and those <50 years old (younger group). After propensity score matching, the overall pancreatic graft survival at 1, 5, and 10 years after transplantation in the older group was 82.8%, 71.8%, and 69.5%, respectively, which was almost the same as in the younger group (84.9%, 70.2%, and 67.4%, respectively). No donor factors markedly influenced the pancreatic graft survival, and the outcomes of pancreas transplantation from ECDs ≥50 years old were comparable to those from younger donors.

An Examination of Donor Factors That Impact the Results of the Glucagon Stimulation Test as an Assessment of the Pancreatic Graft Endocrine Function

“…The cutoff value for donor age was set to 50 years, which is often discussed as a marginal donor criterion for pancreas transplantation with graft survival as an outcome. [11][12][13]15 It was revealed that pancreatic grafts from donors 50 years or older were shown to have a poorer endocrine function in comparison with those from younger donors in this study. In addition to having a negative impact on pancreatic graft survival, 14 donation from older donors and donors who have died of CVA is associated with the possibility of atherosclerosis, which may result in reduced insulin secretion ability.…”

Different timing and risk factors of cause-specific pancreas graft loss after simultaneous pancreas kidney transplantation

“…Furthermore, due to the pooling of the various causes of pancreas graft loss, the statistical analyses may have overestimated the significance of certain factors. Ito et al demonstrated that no factors significantly influenced pancreatic graft survival in a multivariate analysis of post-PTx outcomes based on the Japanese database 19 . If they had performed the analysis based on cause-specific subgroups, their results would have been similar to those reported in the present study.…”

Analysis of the results of pancreas transplantation in one transplant center in Russia

“…1-, 5-и 10-летняя выживаемость реципиентов, согласно данным трансплантационных центров, колеблется в пределах от 82 до 100%, от 81 до 95% и от 67 до 83% соответственно; почечного трансплантата -от 80 до 98%, от 63 до 94% и от 57 до 81% соответственно; ТПЖ -от 71 до 95%, от 59 до 94%, от 53 до 71% соответственно [7][8][9][10][11][12][13][14][15][16]…”