Comparison of Recipient Outcomes Following Transplant From Local Versus Imported Pancreas Donors

Abstract

The shortage of deceased donor organs for solid organ transplantation continues to be an ongoing dilemma. One approach to increase the number of pancreas transplants is to share organs between procurement regions. To assess for the effects of organ importation, we reviewed the outcomes of 1014 patients undergoing deceased donor pancreas transplant at a single center. We performed univariate and multivariate analyses of the association of donor, recipient and surgical characteristics with patient outcomes. Organ importation had no effect on graft or recipient survival for recipients of solitary pancreas transplants. Similarly, there was no effect on technical failure rate, graft survival or long-term patient survival for simultaneous kidneypancreas (SPK) recipients. In contrast, there was a significant and independent increased risk of death in the first year in SPK recipients of imported organs. SPK recipients had longer hospitalizations and increased hospital costs. This increased medical complexity may make these patients more susceptible to short-term complications resulting from the longer preservation times of import transplants. These findings support the continued use of organ sharing to reduce transplant wait times but highlight the importance of strategies to reduce organ preservation times.

A Composite Risk Model for Predicting Technical Failure in Pancreas Transplantation

“…For any donor/recipient offer the only modifiable risk factor is preservation time. We have previously shown similar results with local versus imported pancreas donors, with the only impact of importation being longer preservation time . Strategies that reduce preservation time such as charter flights for imported organs could effectively reduce the number of risk factors from two down to one, thereby increasing the number of organs utilized and improving overall outcomes.…”

HLA-A, -B, -C, -DR, and -DQ Matching in Pancreas Transplantation: Effect on Graft Rejection and Survival

“…Details of our surgical approach, immune profiling, immunosuppression, and recipient and donor database have been previously reported (11,12). (13,14).…”

Retrieval of the pancreas allograft for whole‐organ transplantation

“…Using clearance of the portal venous effluent to determine volume of flush ex vivo is not advisable for the pancreas because it is difficult to exsanguinate the spleen. In the last decade, it is become increasingly apparent that minimizing cold ischemia (<12 h) is one of the single most important predictors of success in pancreas transplantation irrespective of donor quality or method of preservation (36)(37)(38)(39)(40).…”