Schenker P, Vonend O, Ertas N, Wunsch A, Viebahn R
Department of Surgery, Knappschafts-Hospital, Ruhr-University of Bochum, Bochum, Germany.
Transplant Proc. 2010 Jan-Feb;42(1):178-80. doi: 10.1016/j.transproceed.2009.12.036.
Within recent years, more marginal donors have been offered to Eurotransplant. To help identify suitable pancreas donors, the Eurotransplant Pancreas Advisory Committee introduced a donor score system (P-PASS). Little is known about the influence of P-PASS on long-term pancreas graft survival.
From June 1994 to September 2009, we performed 405 pancreas transplantations. In a retrospective study we analyzed P-PASS in 318 cases. Pancreas grafts from donors with P-PASS < 17 (n = 146) analyzed for graft and patient survival as well as for surgical complications were compared with donors of a PASS > or = 17 (n = 172). The mean follow-up was 7.2 +/- 4.3 years.
Recipient characteristics were comparable in both groups. Mean P-PASS was 16.7 +/- 2.7 for both groups: 14.3 +/- 1.5 for P-PASS < 17 and 18.8 +/- 1.6 for P-PASS > or = 17. Pancreas graft survival rates for 1, 5, and 10 years were 85%, 77%, and 73% among P-PASS < 17 and 81%, 73%, and 64% among P-PASS > or = 17 groups (P = .12). There were 12 (8.2%) cases of venous thrombosis in the <17 group and 22 (12.7%) in the > or =17 group (P < .05). The relaparotomy rate was significant higher (38.7% vs 28.7%) and duration of hospital treatment longer (40.2 vs 32 days) in the P-PASS > or = 17 group (P < .05). There was no significant difference in patient or kidney graft survival between groups.
The data demonstrated that utilization of pancreas grafts from donors with a P-PASS > or = 17 resulted in good overall outcomes and could expand the organ donor pool. There was no correlation between P-PASS and long-term patient or graft outcome. Complications requiring relaparotomy were more frequent among patients after transplantation from donors with higher P-PASS.
近年来，更多边缘供体被提供给欧洲移植组织。为了帮助识别合适的胰腺供体，欧洲移植胰腺咨询委员会引入了供体评分系统（P-PASS）。关于P-PASS对胰腺移植长期存活的影响知之甚少。
1994年6月至2009年9月，我们进行了405例胰腺移植。在一项回顾性研究中，我们分析了318例患者的P-PASS。将P-PASS＜17（n = 146）的供体的胰腺移植物的移植物和患者存活情况以及手术并发症与P-PASS≥17（n = 172）的供体进行比较。平均随访时间为7.2±4.3年。
两组患者的受体特征具有可比性。两组的平均P-PASS为16.7±2.7：P-PASS＜17组为14.3±1.5，P-PASS≥17组为18.8±1.6。P-PASS＜17组1年、5年和10年的胰腺移植物存活率分别为85%、77%和73%，P-PASS≥17组分别为81%、73%和64%（P = 0.12）。＜17组有12例（8.2%）发生静脉血栓形成，≥17组有22例（12.7%）（P＜0.05）。P-PASS≥17组的再次剖腹手术率显著更高（38.7%对28.7%），住院治疗时间更长（40.2天对32天）（P＜0.05）。两组之间的患者或肾移植存活率无显著差异。
数据表明，使用P-PASS≥17的供体的胰腺移植物可产生良好的总体结果，并可扩大器官供体库。P-PASS与患者或移植物的长期结局之间无相关性。P-PASS较高的供体移植后的患者中，需要再次剖腹手术的并发症更常见。
