The impact of donor organ extraction time on pancreas graft survival

M. Leemkuil, F. Messner, S. Benjamens, J.F. Krendl, H.G.D. Leuvenink, C. Margreiter, R.A. Pol

Wednesday 4 march 2020

14:40 - 14:50h at Theaterzaal

Parallel session: Parallel sessie III – Klinische abstracts

Background: Prolonged cold and warm ischemia are known to have a deleterious effect on pancreas graft survival. Recently published evidence suggests that donor organ extraction time, defined as time from the initial phase of organ cooling directly after cross clamping until organ recovery from the abdominal cavity, might impact early graft function after liver and kidney transplantation. Whether this period has an adverse effect on pancreas function is not known.

Methods: In this dual center retrospective study, the effect of donor pancreas extraction time on short- and long-term graft survival was evaluated. All recipients from pancreas transplants performed between 1996 and 2018 at the University Medical Center Groningen, the Netherlands, and the Medical University Innsbruck, Austria, were included provided the pancreas extraction time was available. Graft survival was analyzed in both univariate and multivariable analysis and Kaplan-Meier analysis.

Results: A total of 317 patients were included, of which 305 (96.2%) received a pancreas graft from a Donation after Brain Death (DBD) donor and 12 (3.8%) from a Donation after Circulatory Death (DCD) donor. Median extraction time (IQR) was 64 minutes (52-79). 1-, 5-, and 10-year death censored graft survival was 85.7%, 76.7% and 61.9% respectively. Donor pancreas extraction time did not influence graft- and patient survival at 3 months, 1, 5 and 10 years. In addition to pancreas extraction time, the following significant factors in univariate analysis were added to a multivariable analysis: donor age, donor sex, Pancreas Donor Risk Index (PDRI), transplant type, first or re-transplantation. Multivariable analysis showed that donor age, PDRI and transplant type had a significant independent effect on pancreas graft survival, but not pancreas extraction time.

Conclusions: Our data suggest that donor extraction time does not influence pancreas graft survival in this large multicenter analysis.