Prolonged preservation increases surgical complications after pancreas transplants

• Published in: Surgery 2000-05, Vol.127 (5), p.545-551
• Main Authors: Humar, Abhinav, Kandaswamy, Raja, Drangstveit, Mary Beth, Parr, Elizabeth, Gruessner, Angelika G., Sutherland, David E.R.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Humans; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Organ Preservation; Pancreas Transplantation - adverse effects; Postoperative Complications - epidemiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1067/msy.2000.104742

Background. Prolonged preservation of the donor organ may result in delayed graft function or non-function after most organ transplants. We studied whether or not prolonged preservation increases surgical complications after pancreas transplants. Methods. Between January 1, 1994, and September 30, 1998, a total of 294 recipients underwent cadaver pancreas transplants at our institution. Recipients were analyzed in 2 groups: those with pancreas preservation time ≤ 20 hours (n = 211) versus > 20 hours (n = 83). Results. Demographic data were similar between the 2 groups, except that mean donor age in the prolonged preservation group was significantly lower. Despite use of younger donors, prolonged preservation was associated with an increased incidence of surgical complications, most notably leaks, thrombosis, and wound infections. Grafts with prolonged preservation were more often noted by the transplant surgeon to be edematous after reperfusion, although the incidence of hyperamylasemia posttransplant did not differ between the 2 groups. Graft and patient survival rates also did not differ between the 2 groups. The incidence of early graft loss (< 3 months) was, however, higher in the prolonged preservation group (20.5% versus 9.0%, P =.04). Conclusions. Prolonged preservation of the donor organ increases the incidence of surgical complications after pancreas transplants. All attempts should be made to minimize preservation time, keeping it below 20 hours, if possible. (Surgery 2000;127:545–51)