Pancreas Transplantation From Donors After Cardiac Death

Siskind, E. J.; Akerman, Meredith; Maloney, Caroline; Huntoon, Kristin; Alex, Asha; Siskind, Tamar; Bhaskeran, Madhu; Ali, Nicole; Basu, Amit; Molmenti, Ernesto P.; Ortíz, Jorge

doi:10.1097/mpa.0000000000000084

Cited by 39 publications

(31 citation statements)

References 13 publications

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“…Deceased donor type was not a risk factor for pancreas damage, unlike kidney or liver procurement where DCD donors appear to have higher rates of injuries (10,13). This finding is difficult to explain, but it is reassuring given the high proportion of DCD pancreas donors in the UK and their acceptable short-term outcomes (4,19).…”

Section: Discussionmentioning

confidence: 80%

A Registry Analysis of Damage to the Deceased Donor Pancreas During Procurement

Ausania

Drage

Manas

et al. 2015

American Journal of Transplantation

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Surgical injury to the pancreas is thought to occur commonly during procurement. The UK Transplant Registry was analyzed to determine the frequency of pancreatic injuries, identify factors associated with damage, and assess the impact of injuries on graft survival. Twelve hundred ninety-six pancreata were procured from donation after brain death donors, with 314 (19.5%) from donation after circulatory death donors. More than 50% of recovered pancreata had at least one injury, most commonly a short portal vein (21.5%). Liver donation, procurement team origin, hepatic artery (HA) arising from the superior mesenteric artery (SMA), and increasing donor BMI were associated with increased rates of pancreas damage on univariate analyses; on multivariate analysis only the presence of an HA from the SMA remained significant (p ¼ 0.02). Six hundred forty solid organ pancreas transplants were performed; 238 had some form of damage. Overall, there was no difference in graft survival between damaged and undamaged organs (p ¼ 0.28); however, graft loss was significantly more frequent in pancreata with arterial damage (p ¼ 0.04) and in those with parenchymal damage (p ¼ 0.05). Damage to the pancreas during organ recovery is more common than other organs, and meticulous surgical technique and awareness of damage risk factors are essential to reduce rates of procurement-related injuries.

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Section: Discussionmentioning

confidence: 80%

A Registry Analysis of Damage to the Deceased Donor Pancreas During Procurement

Ausania

Drage

Manas

et al. 2015

American Journal of Transplantation

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“…Two studies reported survival but not in a way we could use the data, so we were unable to include these in the overall analysis. 8,29 Overall, results indicated there was no significant difference in allograft survival between DCD and DBD pancreases (HR, 0.98; 95% CI, 0.74-1.31; P = 0.92) (see Figure 2). There was no evidence of heterogeneity among these studies (P = 0.47).…”

Section: Survivalmentioning

confidence: 78%

“…6 Although recent studies report that DCD kidney transplants have similar outcomes to donor after brain death (DBD) kidney transplants, liver transplants from DCD organs are associated with more complications and reduced survival. 7 Promisingly, some large studies comparing pancreas transplants from DCD and DBD donors demonstrated similar patient survival and allograft survival across these groups 8 and similar rates of allograft survival at 10 years. 9 Guidelines for DCD donor organ retrieval from the American Society of Transplant Surgeons suggest that optimal withdrawal of ventilatory and organ perfusion support will occur in the operating room where heparin administration and antemortem cannulation may be used.…”

mentioning

confidence: 97%

Outcomes From Pancreatic Transplantation in Donation After Cardiac Death

Shahrestani¹,

Webster

Lam

et al. 2017

Transplantation

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“…Despite these benefits, there has been a 30% decline in the number of pancreas transplants performed in United States since reaching a peak in 2004, when 1484 pancreas transplants were performed . Fewer transplant referrals, improvement in patient‐centered diabetes management, a proportional rise in donor after cardiac death (DCD) donation, and increased discard rates may all be factors in declining pancreas transplant activity …”

Section: Introductionmentioning

confidence: 99%