Simultaneous en-bloc pancreas and kidney transplantation from a small pediatric donor after circulatory death

Am J Transplant. 2019 Mar;19(3):929-932. doi: 10.1111/ajt.15044. Epub 2018 Aug 27.

Abstract

Simultaneous pancreas and kidney transplantation (SPKT) is an effective treatment option for patients with type 1 diabetes and end stage renal disease. Increasing demands for organs for transplantation coupled with a rise in age and size of adult donors has led to greater utilization of pediatric donors, and with good outcomes. Nonetheless, there remains reticence among transplant surgeons to transplant pancreases from small pediatric donors despite the optimal characteristics and macroscopic features of the younger pancreas. We report a successful case of SPKT from a small pediatric donor and explore the aspects of potential concern that might have led some clinicians to decline these organs. We also discuss the measures taken to overcome potential obstacles to successful transplantation from this donor source, and the rationale behind them.

Keywords: clinical research/practice; diabetes; donors and donation; donors and donation: extended criteria; organ procurement and allocation; organ transplantation in general; pancreas/simultaneous pancreas-kidney transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Child, Preschool
  • Death
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Graft Survival*
  • Humans
  • Kidney Transplantation / methods*
  • Pancreas Transplantation / methods*
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement / methods*
  • Treatment Outcome