Deceased organ donor factors influencing pancreatic graft transplantation and survival

Criteria for organ acceptance in brain‐dead organ donors remain inconsistent, especially when concerning pancreatic transplants. We sought to examine donor‐specific predictors of pancreatic graft use and survival to better guide the selection and management of potential donors. A prospective observa...

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Bibliographic Details
Published in:Clinical transplantation 2019-06, Vol.33 (6), p.e13571-n/a
Main Authors: Sally, Mitchell B., Ellis, Margaret Katherine, Hutchens, Michael, Groat, Tahnee, Swanson, Elizabeth, Patel, Madhukar S., Niemann, Claus U., Malinoski, Darren J.
Format: Article
Language:English
Subjects:
Adult
Brain Death
critical care
donation after brain death
Donor Selection - methods
Female
Follow-Up Studies
Humans
insulin
Male
Middle Aged
organ acceptance
organ procurement
Pancreas Transplantation - mortality
Prognosis
Prospective Studies
Survival Rate
Tissue and Organ Procurement - standards
Tissue Donors - supply & distribution
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Summary:Criteria for organ acceptance in brain‐dead organ donors remain inconsistent, especially when concerning pancreatic transplants. We sought to examine donor‐specific predictors of pancreatic graft use and survival to better guide the selection and management of potential donors. A prospective observational study of all donors from ten organ procurement organizations was conducted from March 2012 to January 2015. Critical care endpoints were collected at 4 standardized time points. Data associated with pancreatic transplantation and graft survival rates were first determined using univariate analyses, and then logistic regression was used to identify independent predictors of these two outcomes. From 1819 donors, 238 (13.1%) pancreata were transplanted, and at a mean follow‐up of 192 days, 218 (91.6%) grafts had survived. After regression analysis, donor age (OR = 0.89), HgbA1C (OR = 0.07), and achieving the donor management goal (DMG) for ejection fraction at allocation of ≥50% (OR = 3.29) remained as independent predictors of pancreatic utilization. On regression analysis, graft survival was independently predicted by lower donor age (OR = 0.93) and achieving the DMGs for mean arterial pressure (60‐110 mm Hg) and glucose (≤180 mg/dL) at separate time points. These results may help guide the management and selection of potential pancreatic donors after brain death.
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.13571