How to Recognize a Suitable Pancreas Donor: A Eurotransplant Study of Preprocurement Factors

doi:10.1016/j.transproceed.2008.03.142

Transplantation Proceedings

Volume 40, Issue 5, June 2008, Pages 1275-1278

Presented at Belgian Transplantation Society (BTS) congress on March 27, 2007 in Brussels, Belgium and at the Deutsche Transplantations Gesellschaft (DTG) congress on October 11, 2007 in Mainz, Germany.

https://doi.org/10.1016/j.transproceed.2008.03.142 Get rights and content

Abstract

Introduction

Because of the increasing demand for pancreas transplantation, more marginal donors are offered to Eurotransplant. The aim of this study was to validate a donor quality score that would facilitate recognition of a suitable pancreas donor among all reported donors.

Materials and methods

We analyzed all 3180 consecutively reported pancreas donors for the period between January 1, 2002 and June 30, 2005 and determined the influence of the preprocurement pancreas suitability score (P-PASS) on the acceptance of a pancreas. We defined a range and point weight for each variable based on clinical expertise and known literature.

Results

Multiple regression analysis using pancreas acceptance as an outcome variable identified P-PASS ≥ 17 as a significant cutoff point (P < .001). Pancreata from donors with P-PASS ≥ 17 were three times more likely to be refused.

Conclusion

The donor score can help in screening for potential pancreas donors, where an ideal donor has a P-PASS < 17. Our data demonstrate that consideration of a combination of preprocurement factors can help identify a suitable pancreas donor. Therefore, we recommend that a pancreas donor score be calculated for each potential pancreas donor, and all donors with a P-PASS < 17 should be considered for pancreas donation.

Section snippets

Materials and Methods

The Eurotransplant Pancreas Advisory Committee defined a pancreas donor quality score based on nine objective clinical parameters available at time of donor reporting, called the “preprocurement pancreas allocation suitability score” (P-PASS; Table 1). The assignment of weights and points was based on medical expertise and literature review and should reflect the likelihood of pancreas acceptance.

Source data for this study were obtained from the donor database of the Eurotransplant

Demographics

Between January 1, 2002 and June 30, 2005, 3180 consecutive postmortem, heart-beating pancreas donors were reported from the Eurotransplant area to the central office. Of these, 1005 pancreata were directly considered for pancreas islet allocation and excluded from the study. The pancreas was offered for organ allocation in the 2175 remaining donors, and their demographic statistics, stratified for acceptance, are provided in Table 2. Acceptance rates of the offered pancreata, stratified by

Discussion

Because the incidence of diabetes mellitus type I is increasing,⁵ the demand for pancreas transplants will continue to increase. The transplant community is well aware of the increased demand for pancreas transplants, which is reflected in a larger proportion of reported pancreata.⁶ Similar to the trend seen with kidney donors,⁷ many potential pancreas donors are labeled as marginal donors; an ideal pancreas donor is 10 to 40 years of age and weighs between 30 and 80 kg.⁸ In reality, the group

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Citation Excerpt :
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: On behalf of the EPAC members: Prof Dr R.G. Bretzel, Prof Dr F.H.J. Claas, Prof Dr P. Hengster, Prof Dr J. van Hooff, Dr A. Kahl, Prof Dr C. Mathieu, Dr J. Ringers, Prof Dr J.P. Squifflet, and Prof Dr R. Viebahn.

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Organ donationHow to Recognize a Suitable Pancreas Donor: A Eurotransplant Study of Preprocurement Factors

Abstract

Introduction

Materials and methods

Results

Conclusion

Section snippets

Materials and Methods

Demographics

Discussion

Am J Transplant

Transpl Int

Transplant Proc

Pancreas transplantation: indications and consequences

Endocr Rev

Organ donation
How to Recognize a Suitable Pancreas Donor: A Eurotransplant Study of Preprocurement Factors