The impact of donor pancreas extraction time on graft survival and postoperative complications in pancreas transplant recipients

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 21; no. 6; pp. 1191 - 1198
• Main Authors: Leemkuil, Marjolein, Messner, Franka, Benjamens, Stan, Krendl, Felix J., Leuvenink, Henri GD, Margreiter, Christian, Pol, Robert A.
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.09.2021; Elsevier Limited
• Subjects: Abdomen; Comorbidity; Coronary vessels; Diabetes mellitus (insulin dependent); Donor organ extraction time; End-stage renal disease; Graft survival; Hospitals; Kidney diseases; Kidney transplantation; Liver transplantation; Pancreas procurement; Pancreas transplantation; Pancreas transplants; Patients; Postoperative complications; Regression analysis; Survival; Veins & arteries; Istanbul Turkey; Turkey; Pancreas transplantation; Graft survival; Pancreas procurement; Donor organ extraction time; Postoperative complications
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2021.05.001

Simultaneous pancreas kidney transplantation (SPK) is the best therapeutic option for patients with diabetes mellitus type 1 and end-stage renal disease. Recently, donor organ extraction time has been shown to affect kidney and liver graft survival. This study aimed to assess the effect of pancreas donor extraction time on graft survival and postoperative complications. We retrospectively analyzed all pancreas transplants performed in two Eurotransplant centers. The association of pancreas extraction time with pancreas graft survival was analyzed by a Cox proportional hazards regression analysis after 3 months, 1 and 5 year. Besides, the effect of pancreas extraction time on the incidence of severe postoperative complications was analyzed. A total of 317 pancreas transplants were included in this study. Death-censored pancreas graft survival was 85.7% after one year and 76.7% after five years. Median pancreas donor extraction time was 64 min [IQR: 52–79 min]. After adjustment for potential confounders, death censored graft survival after 30 days (HR 1.01, 95% CI 0.9–1.03 (p = 0.23), 1 year (HR 1.01, 95% CI 0.99–1.03 (p = 0.22) and 5 years (HR 1.00, 95% CI 0.99–1.02 (p = 0.57) was not associated with pancreas donor extraction time. However, extraction time was significantly associated with a higher incidence of Clavien-Dindo ≥3 complications compared to Clavien-Dindo 1 + 2 complications: OR 1.012, 95% CI 1.00–1.02 (p = 0.039). Our findings suggest that although no effect on graft survival was found, limiting pancreas extraction time can have a significant impact on lowering postoperative complications.