Frontiers in Transplantation (Aug 2023)

Pancreas transplantation with grafts obtained from donation after cardiac death or donation after brain death results in comparable outcomes

  • Michael S. Bleszynski,
  • Catherine Parmentier,
  • Alejandro Torres-Hernandez,
  • Samrat Ray,
  • Anila Yousuf,
  • Andrea Norgate,
  • Jeffrey Schiff,
  • Chaya Shwaartz,
  • Gonzalo Sapisochin,
  • Ian McGilvray,
  • Markus Selzner,
  • Trevor W. Reichman

DOI
https://doi.org/10.3389/frtra.2023.1176398
Journal volume & issue
Vol. 2

Abstract

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IntroductionPancreas organ shortages and long recipient waitlist times are critical components that limit recipients from receiving a pancreas transplant. Over the last decade, our center has been using donation after cardiac death (DCD) donors as an adjunct to donation after brain death (DBD) donors to expand the organ pool. The aim of this study was to compare recipient and graft survival between DCD and DBD recipients.MethodsA retrospective single center propensity matched analysis (2011–2020) of 32 DCD vs 96 DBD pancreas transplants was performed.Results8-year recipient survival was similar between DCD and DBD groups (87.4% vs 92.7%, p=0.35) as was simultaneous kidney and pancreas transplant (SPK) 8-year kidney (88.9 vs 96.9%, p=0.219) and pancreas graft survival (77.4% vs 86.7%, p=0.344). There was no difference in vascular thrombosis rate between DCD and DBD pancreas grafts (3.1% vs 7.3%, p=0.73). DCD kidneys had a higher rate of DGF vs DBD kidneys (28.1% vs 6.3%, p=0.004), without any significant difference in long term kidney failure (12.5% vs 8.3%, p=0.5).DiscussionRecipients of DCD grafts demonstrate equivalent long-term patient and graft survival compared to DBD recipients for pancreas transplantation. Increased utilization of well selected DCD donors is a safe strategy to increase the donor pool.

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