Impact of an older donor pancreas on the outcome of pancreas transplantation: single-center experience of the expansion of donor criteria

Surg Today. 2021 Feb;51(2):232-241. doi: 10.1007/s00595-020-02099-z. Epub 2020 Aug 2.

Abstract

Purpose: The impact of using an older donor pancreas on the clinical outcomes of pancreas transplantation (PTx) is unknown. We investigated this by comparing the outcomes of PTx using older and younger donors in a single Japanese center, to expand the donor criteria.

Methods: The subjects were 54 patients who received PTx from deceased donors in our institution. Posttransplant outcomes were analyzed based on donor age, with older donors defined as those aged ≥ 60 years.

Results: The donors included six older (11.1%; aged 64 ± 4 years) and 48 younger donors (88.9%; aged 43 ± 12 years). There was no significant difference in the donor age between the recipients with vs. those without postoperative complications or between those with vs. those without early pancreas graft loss. Long-term outcomes, including overall, pancreas graft, and kidney graft survival after PTx, did not differ significantly between the older and younger donor groups. Graft age, defined as the age of the donor at the time of procurement plus the graft survival period, was not associated with graft loss.

Conclusion: Our results suggest that post-transplant outcomes of PTx using pancreas from older donors aged ≥ 60 years are comparable to those using pancreas from younger donors, and support expansion of the donor pool for transplantation therapy for type 1 diabetes mellitus.

Keywords: Elderly donor; Outcome; Pancreas transplantation; Type 1 diabetes mellitus.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Graft Survival*
  • Humans
  • Japan
  • Living Donors*
  • Male
  • Middle Aged
  • Pancreas / surgery*
  • Pancreas Transplantation*
  • Time Factors
  • Treatment Outcome