Normothermic Regional Perfusion in Controlled Donation After Circulatory Determination of Death Simultaneous Pancreas - Kidney Transplantation

Transplant Proc. 2023 Dec;55(10):2259-2261. doi: 10.1016/j.transproceed.2023.09.007. Epub 2023 Nov 15.

Abstract

Background: Simultaneous pancreas-kidney transplantation is the optimal treatment for patients with type 1 diabetes and renal failure. The use of pancreas grafts from donation after circulatory death (DCD), using normothermic regional perfusion (NRP), is still marginal worldwide, mainly due to possible additional risks of graft dysfunction and complications compared with grafts from donors after brain death.

Methods: Case series of patients who underwent simultaneous pancreas-kidney transplantation after DCD-NRP between January 2018 and September 2022. This study evaluated early postoperative grafts and survival outcomes.

Results: Four patients were included. One patient lost the pancreatic graft due to arterial thrombosis requiring transplantectomy. Another patient required a laparotomy due to hemoperitoneum. Overall, 1-year pancreas and kidney graft survival was 75% and 100%, respectively. One patient developed a lymphoma during the follow-up.

Conclusion: The use of pancreas grafts from DCD after NRP preservation is safe and feasible. Comparative studies with donors after brain death grafts and larger series are required to confirm the feasibility of DCD-NRP pancreas transplantation.

MeSH terms

  • Brain Death
  • Death
  • Graft Survival
  • Humans
  • Kidney Transplantation* / adverse effects
  • Organ Preservation / adverse effects
  • Pancreas
  • Perfusion
  • Retrospective Studies
  • Tissue Donors
  • Tissue and Organ Procurement*