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Underutilization of pancreas donors
Nancy R Krieger1, Jon S Odorico, Dennis M Heisey
1Division of Organ transplatation, Department of Surgery, University of Wisconsin Medical School, Madison, WI 53792, USA.
Transplantation
|April 30, 2003
Summary
Utilizing pancreas grafts from selected, less-than-ideal donors, including pediatric and obese individuals, shows good outcomes. This approach can help expand the organ donor pool for type 1 diabetes mellitus patients.
Area of Science:
- Transplantation immunology
- Organ donation and procurement
- Endocrinology
Background:
- Pancreas transplantation is a primary treatment for type 1 diabetes mellitus.
- A shortage of ideal donors necessitates the use of alternative organ sources.
- Less-than-ideal donor criteria include age, weight, and amylase levels.
Purpose of the Study:
- To evaluate the outcomes of using pancreas grafts from less-than-ideal donors.
- To assess the impact on patient and graft survival after pancreas-kidney transplantation.
- To determine if these donors can expand the organ donor pool.
Main Methods:
- Analysis of 620 simultaneous pancreas-kidney transplantations.
- Comparison of donor organ utilization ratios with national databases.
- Univariate and multivariate analyses of donor factors on patient and graft survival.
Main Results:
- Nationwide underutilization of pancreas grafts is evident.
- Graft survival was comparable for obese, non-heart-beating, pediatric, and hyperamylasemic donors.
- Donors aged 45 and older showed significantly lower graft survival rates (P=0.006).
Conclusions:
- Selected less-than-ideal pancreas donors can be safely utilized.
- This strategy can improve overall outcomes in pancreas transplantation.
- Expanding the donor pool through these donors is feasible.