title: Professionalization of surgical abdominal organ recovery leading to an increase in pancreatic allografts accepted for transplantation in the Netherlands: a serial analysis.
abstract: Professional abdominal organ recovery with certification has been mandatory in the Netherlands since 2010. This study analyses the effects of certification (January 2010-September 2015) on pancreas transplantation and compares it to an era before certification (February 2002-May 2008) for surgical injuries and the number of pancreases transplanted. A total of 264 cases were analysed. Eighty-four recovered pancreases (31.8%) with surgically injuries were encountered. Forty-six of those were surgically salvaged for transplantation, resulting in a total of 226 (85.6%) being transplanted. It was found that certified surgeons recovered grafts from older donors (36.8 vs. 33.3; P = 0.021), more often from donation after circulatory death (DCD) donors (18% vs. 0%; P < 0.001) and had less surgical injuries (21.6% vs. 41.0%; P < 0.001). Certification (OR: 0.285; P < 0.001) and surgeons from a pancreas transplant centre (OR: 0.420; P = 0.002) were independent risk factors for surgical organ injury. Predictors for proceeding to the actual pancreas transplantation were a recovering surgeon from a pancreas transplantation centre (OR: 3.230; P = 0.003), certification (OR: 3.750; P = 0.004), donation after brain death (DBD) (OR: 8.313; P = 0.002) and donor body mass index (BMI) (OR: 0.851; P = 0.023). It is concluded that certification in abdominal organ recovery will limit the number of surgical injuries in pancreas grafts which will translate in more pancreases available for transplantation.
authors.affiliation: Department of Transplantation Surgery, LUMC, Leiden, The Netherlands.
authors.forename: Hwai-Ding
authors.initials: HD
authors.lastname: Lam
authors.affiliation: Department of Transplantation Surgery, LUMC, Leiden, The Netherlands.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Schaapherder
authors.affiliation: Department of Transplantation Surgery, LUMC, Leiden, The Netherlands.
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Kopp
authors.affiliation: Department of Statistics, LUMC, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Transplantation Surgery, LUMC, Leiden, The Netherlands.
authors.forename: Andries E
authors.initials: AE
authors.lastname: Braat
authors.affiliation: Department of Transplantation Surgery, LUMC, Leiden, The Netherlands.
authors.forename: Andrzej G
authors.initials: AG
authors.lastname: Baranski
mesh_terms: D000328:Adult; D064591:Allografts / Q000592:standards*; D002568:Certification; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000592:standards*; D055815:Young Adult
keywords: donation; organ preservation and procurement; pancreas donor; pancreas transplantation