title: The Value of PDRI and P-PASS as Predictors of Outcome After Pancreas Transplantation in a Large European Pancreas Transplantation Center.
abstract: OBJECTIVE
  In 2008, the preprocurement pancreas suitability score (P-PASS) was introduced within Eurotransplant to predict suitability of pancreas donors. A P-PASS of 17 or higher would have lower graft survival compared with pancreatic grafts from donors with a P-PASS lower than 17. In 2010, a continuous model, the pancreas donor risk index (PDRI), was designed. Before using this model in the European donor population, it has to be validated in the European setting.
  
  
  METHODS
  In this study, P-PASS and PDRI were validated using the results of all pancreas transplants performed at our center. The P-PASS and PDRI were compared as both continuous and dichotomous values. The original cutoff point of 17 divided P-PASS groups. Median PDRI (1.24) divided PDRI groups.
  
  
  RESULTS
  In total, 349 pancreas transplantations were performed. The P-PASS of 17 or higher was not associated with graft survival (P = 0.448). The PDRI of 1.24 or higher was associated with reduced graft survival in univariate analysis (P = 0.007) and multivariate analysis (P = 0.002). The PDRI concordance index was 0.69.
  
  
  CONCLUSIONS
  The P-PASS has no predictive value for pancreas graft survival and should not be used in clinical decision making. The PDRI is a significant predictor of pancreas graft survival but should be used carefully, because good results can be achieved with grafts from high-PDRI donors.
authors.affiliation: From the *Division of Transplantation, Departments of Surgery, †Nephrology, and ‡Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Joris J
authors.initials: JJ
authors.lastname: Blok
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Kopp
authors.forename: Merel J
authors.initials: MJ
authors.lastname: Verhagen
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Schaapherder
authors.forename: Johan W
authors.initials: JW
authors.lastname: de Fijter
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Jan
authors.initials: J
authors.lastname: Ringers
authors.forename: Andries E
authors.initials: AE
authors.lastname: Braat
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D016035:Pancreas Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*