European Society for Organ Transplantation (ESOT) Consensus Statement on the Role of Pancreas Machine Perfusion to Increase the Donor Pool for Beta Cell Replacement Therapy

Ferrer-Fàbrega, Joana; Mesnard, B.; Messner, Franka; Doppenberg, Jason B.; Drachenberg, Cinthia B.; Engelse, Marten A.; Johnson, Paul; Leuvenink, Henri G. D.; Oniscu, Gabriel C.; Papalois, Vassilios; Ploeg, Rutger J.; Reichman, Trevor; Scott, William E.; Vistoli, Fabio; Berney, Thierry; Jacobs-Tulleneers-Thevissen, Daniel; Kessaris, Nicos; Weißenbacher, Annemarie; Ogbemudia, Ann Etohan; White, Steve; Branchereau, J.

doi:10.3389/ti.2023.11374

Cited by 3 publications

(1 citation statement)

References 24 publications

(26 reference statements)

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“…The pancreas is particularly susceptible to edema and ischemic damage during retrieval and preservation, which can lead to microcirculatory dysfunction, likely a major reason why pancreatic perfusion has not attracted as much attention as it has for other organs previously [69][70][71]. Nevertheless, recent experimental and initial human trials of pancreatic machine perfusion look promising [69,[72][73][74].…”

Section: Discussionmentioning

confidence: 99%

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

Hau,

Jahn,

Vlachos

et al. 2024

JCM

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Background: Sleep deprivation and disturbances in circadian rhythms may hinder surgical performance and decision-making capabilities. Solid organ transplantations, which are technically demanding and often begin at uncertain times, frequently during nighttime hours, are particularly susceptible to these effects. This study aimed to assess how transplant operations conducted during daytime versus nighttime influence both patient and graft outcomes and function. Methods: simultaneous pancreas–kidney transplants (SPKTs) conducted at the University Hospital of Leipzig from 1998 to 2018 were reviewed retrospectively. The transplants were categorized based on whether they began during daytime hours (8 a.m. to 6 p.m.) or nighttime hours (6 p.m. to 8 a.m.). We analyzed the demographics of both donors and recipients, as well as primary outcomes, which included surgical complications, patient survival, and graft longevity. Results: In this research involving 105 patients, 43 SPKTs, accounting for 41%, took place in the daytime, while 62 transplants (59%) occurred at night. The characteristics of both donors and recipients were similar across the two groups. Further, the rate of (surgical) pancreas graft-related complications and reoperations (daytime 39.5% versus nighttime 33.9%; p = 0.552) were also not statistically significant between both groups. In this study, the five-year survival rate for patients was comparable for both daytime and nighttime surgeries, with 85.2% for daytime and 86% for nighttime procedures (p = 0.816). Similarly, the survival rates for pancreas grafts were 75% for daytime and 77% for nighttime operations (p = 0.912), and for kidney grafts, 76% during the day compared to 80% at night (p = 0.740), indicating no significant statistical difference between the two time periods. In a multivariable model, recipient BMI > 30 kg/m2, donor age, donor BMI, and cold ischemia time > 15 h were independent predictors for increased risk of (surgical) pancreas graft-related complications, whereas the timepoint of SPKT (daytime versus nighttime) did not have an impact. Conclusions: The findings from our retrospective analysis at a big single German transplant center indicate that SPKT is a reliable procedure, regardless of the start time. Additionally, our data revealed that patients undergoing nighttime transplants have no greater risk of surgical complications or inferior results concerning long-term survival of the patient and graft. However, due to the small number of cases evaluated, further studies are required to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

Hau,

Jahn,

Vlachos

et al. 2024

JCM

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The impact of time to death in donors after circulatory death on recipient outcome in simultaneous pancreas-kidney transplantation

Malik,

Tingle,

Chung

et al. 2024

American Journal of Transplantation

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Pancreas Preservation: Hypothermic Oxygenated Perfusion to Improve Graft Reperfusion

Mesnard,

Ogbemudia,

Bruneau

et al. 2024

Transplantation

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Background. The clinical standard for pancreas preservation for transplantation is static cold storage (SCS). Oxygenation during preservation has been shown to be advantageous in clinical studies. This study evaluates the efficiency of different oxygenation modalities during hypothermic pancreas preservation. Methods. Thirty-two porcine pancreases were procured in a controlled donation after circulatory death model and were divided to be preserved in 8 groups: (1) SCS, (2) hypothermic machine perfusion (HMP), (3) hypothermic oxygenated machine perfusion (HOPE) with 21% oxygen, (4) HOPE and 100%, (5) SCS and oxygen carrier, M101, (6) HMP and M101, (7) HOPE 21% and M101, and (8) HOPE 100% and M101. All the groups underwent 24 h of hypothermic preservation, followed by 2 h of normothermic reperfusion. Oxygen partial pressures were assessed using parenchymal probes. Perfusion parameters, perfusate samples, and tissue biopsies were analyzed. Results. This study showed that HMP was linked to higher tissue oxygen partial pressures, lower succinate levels, and better reperfusion parameters. Furthermore, the addition of M101 to either SCS or HMP was associated with lower succinate and creatinine phosphokinase accumulation, suggesting a protective effect against ischemia. Conclusions. Our research has demonstrated the efficacy of machine perfusion in hypothermic conditions in providing oxygen to the pancreas during preservation and conditioning the pancreatic microvasculature for reperfusion during transplantation. Furthermore, the addition of M101 suggests a protective effect on the graft from ischemia.

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European Society for Organ Transplantation (ESOT) Consensus Statement on the Role of Pancreas Machine Perfusion to Increase the Donor Pool for Beta Cell Replacement Therapy

Cited by 3 publications

References 24 publications

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas–Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years

The impact of time to death in donors after circulatory death on recipient outcome in simultaneous pancreas-kidney transplantation

Pancreas Preservation: Hypothermic Oxygenated Perfusion to Improve Graft Reperfusion

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