title: The Importance and Utility of Hemoglobin A1c Levels in the Assessment of Donor Pancreas Allografts.
abstract: Hemoglobin A1C (HbA1c) levels are often obtained in potential pancreas graft donors to assess the overall long-term functional glycemic control or the possibility of unrecognized diabetes. Although routinely measured, the impact of donor HbA1c levels on pancreas graft outcomes has not been reported. Here, we researched the relationship between donor HbA1c levels and postoperative pancreas graft survival.
  
  
  
  Data from 266 pancreas transplant patients including 182 simultaneous kidney-pancreas and 84 pancreas alone transplants were reviewed for the study. The patients were separated into groups according to their HbA1c levels (5 groups: HbA1c < 5.0, 5.0-5.4, 5.5-5.9, ≥6.0 % and not available, or 2 groups: HbA1c <5.7, ≥5.7%). Overall, death-censored and technically successful pancreas graft survival and rejection rates of each group were compared. In the case of technically successful graft survival, graft losses due to technical problems in the first 60 days were excluded.
  
  
  
  All groups were similar with regard to donor variables including age, sex, ABO blood type, ethnicity, donor type and recipient variables including recipient age, sex, induction agents and maintenance treatment. Mean follow-up time was 4.2 ± 1.97 years. The overall graft survivals and death censored graft survivals among groups were not statistically different from one other (P > 0.05). Additionally, excluding early technical losses in 18 patients did not reveal any differences in graft survivals. Patient survival and biopsy-proven acute rejections were statistically similar among HbA1c strata.
  
  
  
  This univariate retrospective analysis of a single center/organ procurement organization use of HbA1c shows that donor HbA1c levels between 3.5 and 6.2 in otherwise transplantable pancreata are not associated with different short-term outcomes.
authors.affiliation: 1 Division of Transplantation, Department of Surgery, University of Wisconsin School Medicine and Public Health Madison, WI. 2 University of Wisconsin Organ and Tissue Donation Madison, WI.
authors.forename: Emre
authors.initials: E
authors.lastname: Arpali
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Scalea
authors.forename: Robert R
authors.initials: RR
authors.lastname: Redfield
authors.forename: Lynn
authors.initials: L
authors.lastname: Berg
authors.forename: Dixon B
authors.initials: DB
authors.lastname: Kaufman
authors.forename: Hans W
authors.initials: HW
authors.lastname: Sollinger
authors.forename: Bridget
authors.initials: B
authors.lastname: Welch
authors.forename: Glen
authors.initials: G
authors.lastname: Leverson
authors.forename: Jon S
authors.initials: JS
authors.lastname: Odorico
mesh_terms: D000328:Adult; D064591:Allografts; D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006084:Graft Rejection / Q000097:blood* / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D008297:Male; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin