Department of Nephrology, Monash Health, Clayton, Victoria, Australia.
Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, Victoria, Australia.
Ann Transplant. 2021 May 25;26:e930787. doi: 10.12659/AOT.930787.
BACKGROUND Current solid organ pancreas transplantation protocols have differing donor criteria for donor pancreas acceptance and recipient eligibility criteria for transplant workup. We quantified this variation and compared current Australia and New Zealand (ANZ) solid pancreas transplant eligibility criteria with current international practice. MATERIAL AND METHODS A survey of donor and recipient eligibility criteria for solid pancreas transplantation was disseminated to 85 transplant units in 23 countries. Responses were grouped by regions (ANZ, North America, Eurotransplant, Europe, United Kingdom) and analyzed for significant differences between regions and for ANZ compared to all other regions. RESULTS Responding UK pancreas transplant units reported the highest mean donor upper age limit (61 years old) and the highest mean donation after cardiac death donor (DCD) age limit (55 years old). All responding UK and USA units utilized DCD pancreas donors and accepted suitable type 2 diabetes (T2DM) recipients for pancreas transplantation; however, this was less common among responding European or Eurotransplant units. ANZ mean standard and DCD pancreas donor upper age limits (47 and 35 years old, respectively) were lower compared to all other regions (54 years old and 48 years old, respectively). CONCLUSIONS Pancreas donor age limits, DCD pancreas donor utilization, and transplanting T2DM recipients differ between responding pancreas transplant units. ANZ units have more conservative donor upper age limits compared to other responding units. Increased utilization of DCD pancreas donors and T2DM recipients while standardizing pancreas donor age limits might increase donor numbers and improve access to solid pancreas transplantation both locally and abroad.
目前的实体器官胰腺移植方案对供体胰腺的接受标准和受体接受移植评估的标准存在差异。我们量化了这种差异，并比较了澳大利亚和新西兰（ANZ）现行的实体胰腺移植资格标准与当前的国际实践。
向 23 个国家的 85 个移植单位分发了一份关于实体胰腺移植供体和受体资格标准的调查。根据地区（ANZ、北美、欧洲移植协会、欧洲、英国）对这些答复进行分组，并分析了地区之间以及与所有其他地区相比的显著差异。
参与调查的英国胰腺移植单位报告的供体最高平均年龄上限（61 岁）和心脏死亡供体（DCD）最高平均年龄上限（55 岁）最高。所有参与调查的英国和美国单位都使用 DCD 胰腺供体，并接受适合胰腺移植的 2 型糖尿病（T2DM）受者；然而，在参与调查的欧洲或欧洲移植协会单位中，这种情况较少见。与其他所有地区相比，ANZ 的标准和 DCD 胰腺供体的平均年龄上限（分别为 47 岁和 35 岁）较低（分别为 54 岁和 48 岁）。
参与调查的胰腺移植单位之间在胰腺供体年龄限制、DCD 胰腺供体的使用以及 T2DM 受者的移植方面存在差异。与其他参与单位相比，ANZ 单位的供体年龄上限更为保守。增加 DCD 胰腺供体和 T2DM 受者的利用率，同时标准化胰腺供体年龄上限，可能会增加供体数量，并在本地和国外改善实体胰腺移植的机会。
