Pancreas Transplantation From Pediatric Donors: A United Network for Organ Sharing Registry Analysis.
Pancreas grafts from pediatric donors are still considered "not ideal." Perceived concerns are related to low islet mass and potential for graft thrombosis.



The study evaluated all pancreas transplants from January 2000 to May 2015 using the Organ Procurement and Transplant Network database. Comparative analysis of recipient and graft survival was performed between pediatric (≤18 years) and adult donors. In the pediatric group, the outcomes were stratified based on donor age (≤6, 7-12, and 13-18 years) and weight (<30, 30-95, and >95 kg).



In the selected era, 18 430 pancreas transplants were performed from 4915 pediatric donors (27%). Short-term graft and patient survivals were comparable between pediatric and adult donors. Ten-year patient and graft survivals were higher in the pediatric donor group: (70% and 54% vs 68% and 51%, P = 0.001). However, very-low-weight pediatric donors (<30 kg) resulted in worse graft survival in the long term (44% at 10 years, P = 0.006).



Pediatric donor pancreas transplants had comparable patient and graft survival to the adult donor transplants. However, the islet mass of very small donors could influence long-term graft survival if the weights of donors and recipients are not properly matched. Usage of "very small" pediatric donors was not associated with higher incidence of technical complications or early graft loss.
1 Department of Surgery, University of Illinois, Chicago, IL. 2 Department of Pharmacy Practice, University of Illinois, Chicago, IL. 3 Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Mario
M
Spaggiari
Martha
M
Bissing
Maya
M
Campara
Chun-Chieh
CC
Yeh
Ivo
I
Tzvetanov
Hoonbae
H
Jeon
Enrico
E
Benedetti
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016035:Pancreas Transplantation / Q000592:standards*; D012042:Registries; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*