Outcomes of extended donors in pancreatic transplantation with portal-enteric drainage.
OBJECTIVE
Limited data are available on extended (EX) donor criteria in pancreatic transplantation (PTX).


METHODS
This retrospective study from February 2007 through April 2007 compared 2 cohorts of simultaneous kidney-pancreas transplantations (SKPT): the first from EX donors, which were defined as age <10 years or > or =45 years, or donation after cardiac death [DCD]), and the second from conventional (CONV) donors.


RESULTS
Among 79 SKPT, 19 (24%) were from EX donors (12 older than age 45 [mean age, 50.2 years], 3 pediatric donors <10, and 4 DCD donors) and the remaining 60 SKPT from CONV donors. The mean donor age was higher in EX than CONV donors (38 vs 25 years, P < .05). There were no other differences between the 2 cohorts. With a similar median follow-up of 29 months, patient, kidney and pancreatic graft survival rates were 89%, 89%, and 79%, for the EX, whereas corresponding outcomes for CONV donors were 93%, 87%, and 80%, respectively (all P = NS). The incidences were similar for delayed kidney graft function (5% in each group), early pancreatic graft loss due to thrombosis (5% EX vs 8% CONV donors), acute rejection (16% EX vs 18% CONV donors), surgical complications, and infections. There were no significant differences in 1-year mean serum creatinine (1.4 mg/dL in each group) or glycohemoglobin (5.2% vs 5.5%) levels between the EX and CONV donor groups, respectively.


CONCLUSIONS
Short-term outcomes among SKPT from selected EX donors were comparable to CONV donors. Donors at the extremes of age and DCD donors may represent underused resources in SKPT.
Singh
R P
RP
Department of General Surgery and Nephrology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina 27157, USA.
Rogers
J
J
Farney
A C
AC
Moore
P S
PS
Hartmann
E L
EL
Reeves-Daniel
A
A
Adams
P L
PL
Gautreaux
M
M
Stratta
R J
RJ
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003643:Death; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D011168:Portal System; D012189:Retrospective Studies; D014019:Tissue Donors; D014850:Waiting Lists