Acceptance criteria of pancreas grafts: how do surgeons decide in Europe?
OBJECTIVE
Some donor factors, such as age, cause of death, and obesity, affect the outcomes of pancreas transplantation. Donors with a high-risk profile are usually not declined for pancreas donation. The purpose of our study was to investigate differences between accepted and refused pancreata after being procured and offered.


METHODS
In a retrospective study we analyzed all offered pancreata (n = 1360) in the "Eurotransplant Area" between May 25, 2002 and September 18, 2003. Included in this study were 525 pancreata transplanted (38.6%) and 608 pancreata refused for medical reasons (44.7%). A total of 227 pancreata (16.7%) refused for other than medical reasons were excluded from this analysis.


RESULTS
The significant differences in the donor profiles between transplanted and refused pancreata were cause of death (P < .001), donor age (P < .001), body mass index (BMI, P < .001), serum lipase and amylase (P < .05) at the time of procurement, and a history of smoking (P = .001) or alcohol abuse (P < .001). No differences were found for serum sodium (P = .188), blood leukocytes (P = .349), serum glucose at the time of procurement (P = .155), amylase and lipase at the time of admission (P = .34; P = .758), and vasopressor use at the time of admission or at the procedure (P = .802; P = .982).


CONCLUSIONS
Even after procuring and offering potentially good pancreata, nearly half the organs are refused for medical reasons. Acceptance criteria in the Eurotransplant region reveal a conservative attitude toward pancreas acceptance.
Wullstein
C
C
Department of General and Vascular Surgery, Goethe University, Frankfurt, Germany. christoph.wullstein@kgu.de
Woeste
G
G
de Vries
E
E
Persijn
G G
GG
Bechstein
W O
WO
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000502:physiology*; D018579:Patient Selection; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome