Simultaneous Pancreas-Kidney Transplant From Donors After Brain Death vs Donors After Circulatory Death: A Single-Center Follow-up Study Over 3 Decades

Transplant Proc. 2019 Apr;51(3):845-851. doi: 10.1016/j.transproceed.2019.01.050. Epub 2019 Jan 26.

Abstract

Background: Despite an increase in the number of pancreas transplants in the Scandiatransplant region in the last decade, there continues to be a gap between demand and supply of transplantable organs. This imbalance has encouraged the transplant community to consider new sources of grafts, such as the reintroduction of donors after circulatory death (DCD) who were the standard donors in our center before 1988.

Material and methods: In this long-term follow-up study, we compare 44 consecutive, simultaneous pancreas kidney transplants performed at Karolinska University Hospital between 1986 and 1991: 21 patients received DCD grafts and 23 received grafts from donors after brain death.

Results: Both groups had similar donor and recipient characteristics, but cold ischemia times were significantly shorter in the DCD group. Warm ischemia times were very short compared with other studies on DCDs. Patient and graft survival rates were similar in both groups.

Conclusion: This study suggests that controlled DCD pancreas and kidney grafts transplanted simultaneously can be a feasible option for reducing organ shortage without any negative impact on the long-term results.

MeSH terms

  • Adult
  • Brain Death
  • Cold Ischemia
  • Death
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Kidney Transplantation / methods*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Pancreas Transplantation / methods*
  • Pancreas Transplantation / mortality
  • Survival Rate
  • Tissue Donors* / supply & distribution
  • Transplants / supply & distribution
  • Warm Ischemia