Effect of blood group and HLA matching on pancreas graft survival with the use of UW solution.
Pancreas graft survival is influenced by various donor and recipient factors. Factors that have posed serious problems to pancreas transplantation have included the limited cold ischemia time, early graft thrombosis, and rejection. A limited cold ischemia time not only causes problems in terms of logistics but also implies limitations with regard to HLA matching and organ exchange. Between August 1988 and August 1989 we performed a prospective, nonrandomized European multicenter study to evaluate the effect of University of Wisconsin (UW) solution on pancreas graft survival. In addition, donor and recipient factors were collected and their influence on graft survival analyzed. Overall pancreas graft survival at 1 and 4 years was 67% and 59%, respectively (n = 62). When only simultaneous pancreas and kidney transplants were included, the graft survival was 70% and 63% at 1 and 4 years, respectively. The incidence of pancreas graft thrombosis was 8%. Cold ischemia time was not found to significantly influence pancreas graft survival even when it exceeded 12 h. Factors that did were HLA-DR matching, simultaneous pancreas and kidney transplantation versus pancreas transplantation alone, and ABO blood group matching. We feel that the use of UW solution for pancreas preservation has contributed to improved pancreas graft survival and has reduced early graft thrombosis despite much longer cold ischemia times of over 12 h. Given this and the significant effect of HLA and blood group matching, we conclude that more attention should be paid to preoperative matching and organ exchange in order to further improve pancreas graft survival.
Hartgrink
H H
HH
Department of Surgery, University Hospital Leiden, The Netherlands.
van Bockel
J H
JH
Hansen
B
B
Thorogood
J
J
Hermans
J
J
de Meester
J
J
Gooszen
H G
HG
Ploeg
R J
RJ
D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000494:pharmacology; D001789:Blood Group Antigens; D005260:Female; D005978:Glutathione / Q000494:pharmacology; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions; D016035:Pancreas Transplantation; D011446:Prospective Studies; D011887:Raffinose / Q000494:pharmacology
D001789:Blood Group Antigens; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose