INFLUENCE OF VARIOUS FACTORS UPON DECISION ON PANCREAS ALLOGRAFT SUITABILITY

Abstract

AAim. To identify factors influencing upon decision on pancreas allograft suitability for transplant and their clinical significance. Materials and methods. We reviewed 95 multiorgan donors under the age of 45, who were considered as pancreas donor between January 2010 and December 2013. 28 pancreata were procured (Group I), 67 pancreata were refused (Group II). Demographic, clinical and laboratory data, anatomical hepatopancreatoduodenal varieties were taken into account. Results. We found that only three factors have an effect on pancreas allograft refusal probability. According to our data, non-transplantation of the liver from the same donor increases the pancreas graft refusal in 4 times. Elevated donor’s sodium and urea blood levels also increase the probability of donor pancreas denial for transplantation. For example, the probability of pancreas graft refusal from the donor with sodium level 145 mmol/l and urea level 6.0 mol/l is only 32%. As compared to the donor with sodium level 160 mmol/l and urea 12.0 mol/l where probability reaches 85%. Other factors: demographic, laboratory, clinical indicators, gepatopancreatoduodenal blood supply variations were not predictive for the procurement decision. Conclusion. Main predictors of pancreas allograft refusal to be taken into account, appropriate correction of donor metabolic disturbances and sufficient experience of the surgeon performing the procurement can increase the availability of pancreas transplantation.

Keywords

• transplantation
• pancreas
• donor
• reperfusion
• risk