Salvalaggio P R, Davies D B, Fernandez L A, Kaufman D B
Department of Surgery, Saint Louis University School of Medicine, St Louis, MO, USA.
Am J Transplant. 2006 May;6(5 Pt 1):1059-65. doi: 10.1111/j.1600-6143.2006.01310.x.
Organs donated after cardiac death (DCD) are used to expand the donor pool. We analyzed the outcomes in the United States of pancreatic transplantation of organs from DCD donors performed between 1993 and 2003. We used the OPTN/UNOS Registry to compare outcomes of primary pancreas allografts from DCD donors and donors after brain death (DBD). The primary endpoints were graft failure and patient death. A national survey regarding the use of DCD donors in pancreas transplantation was conducted among the directors of pancreas transplant centers. Data were obtained on 47 simultaneous pancreas-kidney transplants (SPK) and 10 solitary pancreas transplants from DCD donors and on 2431 SPK and 1607 solitary pancreas transplants from DBD donors. Recipients of a SPK transplants from DCD and DBD donors had equivalent patient and graft survival rates at 1, 3 and 5 years. For recipients of SPK transplants, the wait for organs from DCD donors was significantly shorter than that for organs from DBD donors. SPK recipients of organs from DCD donors had longer hospital stays than did recipients of organs from DBD donors. With renal allografts, the incidence of delayed graft function was almost four times higher with organs from DCD donors than with organs from DBD donors. Selective use of organs from DCD donors is safe for pancreas transplantation.
心脏死亡后捐赠的器官（DCD）被用于扩大供体库。我们分析了1993年至2003年间在美国进行的DCD供体胰腺移植的结果。我们使用器官获取与移植网络/器官共享联合系统（OPTN/UNOS）登记处的数据，比较了DCD供体和脑死亡（DBD）供体的初次胰腺同种异体移植的结果。主要终点是移植物失败和患者死亡。我们对胰腺移植中心主任进行了一项关于胰腺移植中使用DCD供体的全国性调查。获取了47例DCD供体的同期胰肾联合移植（SPK）和10例单独胰腺移植以及2431例DBD供体的SPK和1607例单独胰腺移植的数据。DCD供体和DBD供体的SPK移植受者在1年、3年和5年时的患者和移植物存活率相当。对于SPK移植受者，等待DCD供体器官的时间明显短于等待DBD供体器官的时间。DCD供体器官的SPK受者的住院时间比DBD供体器官的受者更长。对于肾移植，DCD供体器官的移植肾功能延迟发生率几乎是DBD供体器官的四倍。选择性使用DCD供体的器官进行胰腺移植是安全的。
