From the Department of Transplantation, North Shore Long Island Jewish Health System, Hofstra University School of Medicine, Manhasset, NY; and Department of Transplantation, Albert Einstein Medical Center, Philadelphia, PA.
Pancreas. 2014 May;43(4):544-7. doi: 10.1097/MPA.0000000000000084.
There is reluctance to use donation after cardiac death (DCD) organs for fear of worse outcomes due to increased warm ischemia time. Extensive evidence to confirm the quality of DCD pancreas transplants is not manifest.
A united network for organ sharing database review of pancreas transplants performed between 1996 and 2012 was conducted. We compared outcomes and all demographic variables between donors after cardiac death and donors after brain death in pancreas transplantation.
There were 320 DCD pancreas transplants and 20,448 donation after brain death pancreas transplants performed in the United States between 1996 and 2012. There was no statistically significant difference in graft survival or patient survival in pancreas transplantation in DCD versus donation after brain death donors measured at 1-year, 3-year, 5-year, 10-year, and 15-year intervals. There was no significant difference between donor and recipient age, race, sex, and body mass index (BMI) between the groups. There was no significant difference between the recipient ethnicity or time on wait list between the groups.
Pancreata procured by DCD have comparable outcomes to those procured after brain death. Donation after cardiac death pancreas transplant is a viable method of increasing the donor pool, decreasing wait list mortality, and improving the quality of life for type 1 diabetic patients.
由于担心温缺血时间增加会导致更差的结果，人们不愿意使用心死亡后（DCD）器官。目前还没有广泛的证据来证实 DCD 胰腺移植的质量。
对 1996 年至 2012 年间进行的胰腺移植进行了美国器官共享联合网络数据库的回顾。我们比较了心死亡后供体和脑死亡后供体在胰腺移植中的结局和所有人口统计学变量。
在 1996 年至 2012 年间，美国共进行了 320 例 DCD 胰腺移植和 20448 例脑死亡后胰腺移植。在 1 年、3 年、5 年、10 年和 15 年的时间间隔内，DCD 与脑死亡供体相比，胰腺移植的移植物存活率或患者存活率没有统计学上的显著差异。两组间供体和受体的年龄、种族、性别和体重指数（BMI）无显著差异。两组间受体种族或等待名单时间也无显著差异。
通过 DCD 获得的胰腺具有与脑死亡后获得的胰腺相当的结果。DCD 胰腺移植是增加供体库、降低等待名单死亡率和提高 1 型糖尿病患者生活质量的可行方法。
