Donor Characteristics in 1,000 Consecutive Simultaneous Pancreas-Kidney Transplants

In 2003, Krieger et al. from our group published a manuscript which investigated the use of pancreas grafts for transplantation in different UNOS regions in the United States (1). It was reported that the utilization of pancreata showed a wide variation depending on the region. To approach some degree of standardization, we calculated the ratio of pancreata used for transplantation with the number of livers procured and transplanted. Using the data from our own institution, we had experienced that at least 70% of liver donors should provide acceptable pancreas grafts. The results of the study, however, demonstrated that in some regions, less than 20% of liver donors yielded pancreas grafts. Ensuing discussion revealed that the lack of established criteria to predict the outcome of pancreas transplantation based on available donor criteria was one of the reasons many centers, in particular less experienced programs, were hesitant to accept donors other than those expected to provide excellent pancreas grafts, and therefore, outcomes. Since then, few publications have addressed the correlation between available donor criteria and shortor long-term outcomes. One single center report analyzing outcomes in 61 simultaneous pancreas-kidney transplants (SPK) was published in 1995 by Douzdjian et al. (2), and a multi-center European report by Vinkers et al. (3) attempted to establish a donor quality score. During the preparation of this manuscript, the online version of a large-scale analysis using data from the Scientific Registry of Transplant Recipients (SRTR) in 9,401 transplants from 2000 to 2006 became available for review (4). The purpose of this manuscript is to report the donor characteristics in 1,000 consecutively performed SPK transplants at a single center. Pancreas-kidney retrieval and donor management, as well as donor evaluation, were performed by the same organ procurement organization (UW OPO). Retrieval was performed by surgeons trained at our institution. Using only donor data easily available to OPO personnel and surgeons, we attempt here to provide straightforward guidelines regarding the acceptability of pancreas grafts. A unique feature of this study is the fact that long-term follow up is available up to 22 years.