Validation of the Pancreas Donor Risk Index for use in a UK population

Mittal, Shruti; Lee, Fang Jann; Bradbury, Lisa; Collett, David; Reddy, Srikanth; Sinha, Sanjay; Sharples, Edward; Ploeg, Rutger J.; Friend, Peter J.; Vaidya, Anil

doi:10.1111/tri.12563

Cited by 36 publications

(26 citation statements)

References 11 publications

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“…This was mainly due to missing amylase and lipase values (n = 3253) or unknown ICU stay (n = 739). Median (25th-75th percentile) P-PASS was 19 (17)(18)(19)(20). From all 10 444 pancreas donors, P-PASS could be calculated in 9795 cases (93.7%).…”

Section: P-pass Evaluationmentioning

confidence: 99%

“…This donor scoring system, which was one of the first quantitative donor scoring systems, consists solely of donor factors (age, body mass index (BMI), duration of intensive care unit (ICU) stay, duration of asystole, sodium, amylase, lipase and inotropic therapy). The system identifies a suitable pancreas donor, using a cut-off value of 17 (range [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Its intention was to educate and inform transplant professionals, such as ICU clinicians referring potential donors, as well as transplant coordinators reporting donors to Eurotransplant.…”

Section: Introductionmentioning

confidence: 99%

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Donor risk indices in pancreas allocation in the Eurotransplant region

et al. 2016

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SUMMARYPancreas donor selection and recognition are important to cope with increasing organ shortage. We aim to show that the PDRI is more useful than the P-PASS to predict acceptance and should thus be preferred over P-PASS. Eurotransplant donors from 2004 until 2014 were included in this study. PDRI logistical factors were set to reference to purely reflect donor quality (PDRI donor ). PDRI and P-PASS association with allocation outcome was studied using area under the receiver operating characteristic curve (AUROC). Regional differences in donor quality were also investigated. Of the 10 444 pancreata that were reported, 6090 (58.3%) were accepted and 2947 (28.2%) were transplanted. We found that P-PASS was inferior to PDRI donor in its ability to predict organ reporting, acceptance, and transplantation: AUC 0.63, 0.67 and 0.73 for P-PASS vs. 0.78, 0.79 and 0.84 for PDRI donor , respectively. Furthermore, there were significant differences in donor quality among different Eurotransplant countries, both in reported donors and in transplanted organs. PDRI is a powerful predictor of allocation outcome and should be preferred over P-PASS. Proper donor selection and recognition, and possibly a more liberal approach toward inferior quality donors, may increase donation and transplant rates. Transplant International 2016; 29: 921-929

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Section: P-pass Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Donor risk indices in pancreas allocation in the Eurotransplant region

et al. 2016

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“…Organ procurement organizations are the gatekeepers of organ distribution across the United States. Past publications have detailed the standardized criteria‐based classification for livers using MELD scores, kidneys using KDPI, and SPK using the PDRI as well as the process of organ allocation and organ sharing across OPOs . Our study advances the current understanding regarding individual OPO practices and decision‐making in the organ procurement process.…”

Section: Discussionmentioning

confidence: 88%

Disparities in DCD organ procurement policy from a national OPO survey: A call for standardization

Choubey

Siskind

Ortiz

et al. 2020

Clinical Transplantation

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Introduction: Procurement practices across organ procurement organizations (OPOs) for donation after cardiac death (DCD) transplants have not been evaluated. Methods:A national telephone survey of all 58 OPOs inquiring about their procurement practices of DCD organs was conducted. Policies concerning maximum donor body mass index (BMI), location of care withdrawal, pre-mortem heparin administration, vasodilator use, wait times after declaration of death before incisions, inclinations between rapid laparotomy and pre-mortem cannulation, and maximum time before aborting DCD procurement were queried. Results:The survey revealed substantial differences across OPOs. Donor BMI restriction was considered by 36 of 58 OPOs, and 23 sites preferred OR for donor withdrawal of care. Pre-mortem heparin was utilized by 53 OPOs. Only 2 recommended vasodilators. Minimum wait time of 5-minutes was implemented by 41 OPOs. Rapid laparotomy was preferred by 57 organizations. 28 OPOs had a 90-minute limit before aborting DCD procurement. Conclusion:There are substantial variations across OPO protocols for procuring DCD organs. Current practices do not conform to ASTS guidelines for DCD procurement. Further investigations are needed to quantify the impact of OPO policies on transplant outcomes. K E Y W O R D Sasystolic waiting time, pre-mortem cannulation, rapid laparotomy, vasodilators, warm ischemic time

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“…The article by Mittal et al . published in this issue of Transplant International validates the pDRI score in a cohort from the United Kingdom and argues that it can be used as a tool to predict graft survival in their population.…”

mentioning

confidence: 99%

“…A second score, the pDRI (pancreas donor risk index) computed from the Scientific Registry of Transplant Recipients (SRTR) donor and outcome data, was more recently developed in the United States [7]. The article by Mittal et al published in this issue of Transplant International validates the pDRI score in a cohort from the United Kingdom [8] and argues that it can be used as a tool to predict graft survival in their population. This interesting study is undoubtedly of value, but raises a few questions.…”

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confidence: 99%