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Deceased organ donor factors influencing pancreatic graft transplantation and survival
Author(s) -
Sally Mitchell B.,
Ellis Margaret Katherine,
Hutchens Michael,
Groat Tahnee,
Swanson Elizabeth,
Patel Madhukar S.,
Niemann Claus U.,
Malinoski Darren J.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13571
Subject(s) - medicine , logistic regression , transplantation , univariate analysis , organ donation , observational study , organ procurement , surgery , multivariate analysis
Criteria for organ acceptance in brain‐dead organ donors remain inconsistent, especially when concerning pancreatic transplants. We sought to examine donor‐specific predictors of pancreatic graft use and survival to better guide the selection and management of potential donors. A prospective observational study of all donors from ten organ procurement organizations was conducted from March 2012 to January 2015. Critical care endpoints were collected at 4 standardized time points. Data associated with pancreatic transplantation and graft survival rates were first determined using univariate analyses, and then logistic regression was used to identify independent predictors of these two outcomes. From 1819 donors, 238 (13.1%) pancreata were transplanted, and at a mean follow‐up of 192 days, 218 (91.6%) grafts had survived. After regression analysis, donor age (OR = 0.89), HgbA1C (OR = 0.07), and achieving the donor management goal (DMG) for ejection fraction at allocation of ≥50% (OR = 3.29) remained as independent predictors of pancreatic utilization. On regression analysis, graft survival was independently predicted by lower donor age (OR = 0.93) and achieving the DMGs for mean arterial pressure (60‐110 mm Hg) and glucose (≤180 mg/dL) at separate time points. These results may help guide the management and selection of potential pancreatic donors after brain death.