Pancreas transplants from small donors: are the outcomes acceptable? A retrospective study. (18th August 2020)

• Record Type: Journal Article
• Authors: Al‐Qaoud, Talal M.; Odorico, Jon S.; Al‐Adra, David P.; Kaufman, Dixon B.; Sollinger, Hans W.; Leverson, Glen; Welch, Bridget; Redfield, Robert R.
• Is Part Of: Transplant international. Volume 33:Number 11(2020)
• Page Start: 1437
• Page End: 1446
• Publication Date: 2020-08-18
• Subjects: pancreas -- pediatric donor -- transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13711
• Languages: English
• ISSNs: 0934-0874

Abstract

Abstract: Despite good organ quality, pancreata from extremely small pediatric donors (<30 kg) are generally avoided by many centers because of concerns of reduced islet cell mass and early technical failure. Therefore, we sought to compare the outcomes of small pancreas grafts (<30 kg) to those from higher weight donors from transplants performed between 1994 and 2015 ( n = 1183). A total of 33 pancreata were from donors' ≤30 kg (3%), with a mean weight of 23.8 kg and mean age of 7.8 years. Patient survival was similar at 1, 5, and 10 years between recipients of ≤30 and >30 kg donors (≤30 kg: 96.8%, 86.8%, and 78.1% vs. >30 kg: 96.8%, 89.5%, and 79.1%, P = 0.5). Pancreas graft survival at 1, 5, and 10 years was also similar, ≤30 kg: 93.9%, 73.2%, and 61.0% vs. >30 kg: 87%, 73.3%, and 58.3% ( P = 0.7). This graft survival pattern was also seen when comparing pancreata from ≤20 kg donors to those from >20 to 30 kg. Cause of graft loss, and metabolic and physiologic outcomes did not differ between the groups. After assessing the impact of donor weight as a continuous variable and calculating recipient‐to‐donor weight ratio (RDWR), we observed no effect of donor weight on patient and graft outcomes.