AUTHOR=Kaku Keizo , Okabe Yasuhiro , Kubo Shinsuke , Sato Yu , Mei Takanori , Noguchi Hiroshi , Tomimaru Yoshito , Ito Toshinori , Kenmochi Takashi , Nakamura Masafumi 

TITLE=Utilization of the Pancreas From Donors With an Extremely High Pancreas Donor Risk Index: Report of the National Registry of Pancreas Transplantation

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11132

DOI=10.3389/ti.2023.11132

ISSN=1432-2277

ABSTRACT=Pancreas transplants from expanded criteria donors have been widely performed in Japan due to the shortage of brain-dead donors, however, the effectiveness of this strategy has not been evaluated. We retrospectively studied 371 pancreas transplants to evaluate the possibility of pancreas transplantation from expanded criteria donors by the Pancreas Donor Risk Index (PDRI). Patients were divided into low- and high-PDRI groups, with a cut-off value of 2.52. The 1-year pancreas graft survival rate was significantly higher in patients with a low-PDRI than in those with a high-PDRI (92.0% vs 81.0%, P = 0.003). Multivariate analysis showed that PDRI, donor hemoglobin A1c, and pancreas transplantation alone significantly predicted 1-year pancreas graft survival (all P < 0.05). Spline curve analysis revealed that the PDRI was incrementally associated with an increased risk of 1-year graft failure. In the group with a PDRI ≥ 2.87, 8 of the 56 cases resulted in graft failure within 1 month, and all due to graft thrombosis. PDRI is a prognostic factor related to the 1-year graft survival rate. However, pancreas transplantation from donors with a high PDRI showed acceptable results and could be an alternative in the current situation where the donor pool is insufficient.