TY - JOUR
T1 - Outcomes of simultaneous pancreas and kidney transplantation based on donor resuscitation
AU - Messner, Franka
AU - Etra, Joanna W.
AU - Yu, Yifan
AU - Massie, Allan B.
AU - Jackson, Kyle R.
AU - Brandacher, Gerald
AU - Schneeberger, Stefan
AU - Margreiter, Christian
AU - Segev, Dorry L.
N1 - Funding Information:
This work was supported by grant numbers K24DK101828 (Segev), F32DK113719 (Jackson), and K01DK101677 (Massie) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. The data reported here have been supplied by the Minneapolis Medical Research Foundation (MMRF) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government.
Funding Information:
This work was supported by grant numbers K24DK101828 (Segev), F32DK113719 (Jackson), and K01DK101677 (Massie) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. The data reported here have been supplied by the Minneapolis Medical Research Foundation (MMRF) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government.
Publisher Copyright:
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2020/6/1
Y1 - 2020/6/1
N2 - It has been hypothesized that transplanting simultaneous pancreas kidney (SPK) grafts from donors with a history of cardiac arrest and cardiopulmonary resuscitation (CACPR) leads to inferior posttransplant outcomes due to organ hypoperfusion during cardiac arrest and mechanical trauma during resuscitation. Using Scientific Registry of Transplant Recipients data, we identified 13 095 SPK transplants from 2000-2018, of which 810 (6.2%) were from donors with a history of CACPR. After inverse probability of treatment weighting on donor and recipient characteristics, we found that 1-, 5-, and 10-year patient (CACPR: 96.4%, 89.9%, and 78.9%; non-CACPR: 96.3%, 88.9%, and 76.0%; P =.3), death-censored pancreas graft survival (CACPR: 89.3%, 82.7%, 75.0%; non-CACPR: 89.9%, 82.7%, 76.3%; P =.7), and death-censored kidney graft survival (CACPR: 97.0%, 89.5%, 78.2%; non-CACPR: 96.9.9%, 88.7%, 80.0%; P =.4) were comparable between the two groups. There were no differences in the risk of pancreatitis (CACPR: 2.9%, non-CACPR: 2.4%; weighted OR = 0.74 1.22 2.02; P =.4), anastomotic leak (CACPR: 1.6%, non-CACPR: 2.0%; weighted OR = 0.54 1.02 1.93; P >.9), or median length of hospital stay (CACPR: 8 days, non-CACPR: 9 days; P =.6) for recipients of CACPR vs non-CACPR donors. Our findings suggest that CACPR donors could be used to expand the SPK donor pool without compromising short- or long-term outcomes.
AB - It has been hypothesized that transplanting simultaneous pancreas kidney (SPK) grafts from donors with a history of cardiac arrest and cardiopulmonary resuscitation (CACPR) leads to inferior posttransplant outcomes due to organ hypoperfusion during cardiac arrest and mechanical trauma during resuscitation. Using Scientific Registry of Transplant Recipients data, we identified 13 095 SPK transplants from 2000-2018, of which 810 (6.2%) were from donors with a history of CACPR. After inverse probability of treatment weighting on donor and recipient characteristics, we found that 1-, 5-, and 10-year patient (CACPR: 96.4%, 89.9%, and 78.9%; non-CACPR: 96.3%, 88.9%, and 76.0%; P =.3), death-censored pancreas graft survival (CACPR: 89.3%, 82.7%, 75.0%; non-CACPR: 89.9%, 82.7%, 76.3%; P =.7), and death-censored kidney graft survival (CACPR: 97.0%, 89.5%, 78.2%; non-CACPR: 96.9.9%, 88.7%, 80.0%; P =.4) were comparable between the two groups. There were no differences in the risk of pancreatitis (CACPR: 2.9%, non-CACPR: 2.4%; weighted OR = 0.74 1.22 2.02; P =.4), anastomotic leak (CACPR: 1.6%, non-CACPR: 2.0%; weighted OR = 0.54 1.02 1.93; P >.9), or median length of hospital stay (CACPR: 8 days, non-CACPR: 9 days; P =.6) for recipients of CACPR vs non-CACPR donors. Our findings suggest that CACPR donors could be used to expand the SPK donor pool without compromising short- or long-term outcomes.
KW - clinical research/practice
KW - donors and donation
KW - donors and donation: donation after brain death (DBD)
KW - donors and donation: donation after circulatory death (DCD)
KW - donors and donation: donor evaluation
KW - pancreas/simultaneous pancreas-kidney transplantation
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U2 - 10.1111/ajt.15808
DO - 10.1111/ajt.15808
M3 - Article
C2 - 32026618
AN - SCOPUS:85080104054
SN - 1600-6135
VL - 20
SP - 1720
EP - 1728
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 6
ER -