Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Melbourne, Australia; Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, Melbourne, Australia.
Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Melbourne, Australia; Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Transplant Proc. 2021 Sep;53(7):2358-2368. doi: 10.1016/j.transproceed.2021.07.014. Epub 2021 Aug 26.
Donor characteristics help guide donor pancreas acceptance for solid pancreas-kidney transplantation; however, these criteria vary worldwide. Such variation could result in nonuse of potentially transplantable organs. Using a registry cohort, we identified donor characteristics associated with donor pancreas retrieval and subsequent solid pancreas transplantation in Australia and New Zealand.
Australia and New Zealand Organ Donor registry donor data from 2007 to 2016 were used to define cohort 1 (all donors authorized for pancreas retrieval) and cohort 2 (all retrieved donor pancreata considered for solid pancreas transplantation). Donor factors significantly associated with donor pancreas retrieval (cohort 1) and solid pancreas transplantation of retrieved donor pancreata (cohort 2) were determined via multivariable logistic regression.
Nonretrieval and nonuse of solid organ donor pancreas increased throughout the study period, and nonauthorization for pancreas donation remained stable. Donor body mass index, sex, and viral serology were associated with donor pancreas retrieval but not transplantation. Donor age, cause of death, donation after brain death status, terminal serum creatinine, and donor region were associated with both donor pancreas retrieval and acceptance for solid pancreas transplantation with donation after brain death status being the strongest predictor for both outcomes.
Donor age, cause of death, donation after brain death status, terminal serum creatinine, and donor region were associated with both donor pancreas retrieval and subsequent transplantation in Australia and New Zealand. Subsequent correlation of these factors with post-pancreas transplant outcomes would help guide pancreas transplant decisions and minimize nonuse of potentially usable donor pancreata.
供者特征有助于指导实体胰腺-肾联合移植中对供胰腺的接受；然而，这些标准在世界范围内有所不同。这种差异可能导致潜在可移植器官未被使用。本研究使用注册队列，确定了澳大利亚和新西兰与供胰腺获取以及随后实体胰腺移植相关的供者特征。
使用澳大利亚和新西兰器官捐赠者登记处 2007 年至 2016 年的供者数据，定义队列 1（所有授权获取胰腺的供者）和队列 2（所有考虑进行实体胰腺移植的获取的供胰腺）。通过多变量逻辑回归确定与供胰腺获取（队列 1）和获取的供胰腺实体胰腺移植（队列 2）显著相关的供者因素。
整个研究期间，未获取和未使用实体器官供者胰腺的比例不断增加，而未授权捐献胰腺的比例保持稳定。供者体重指数、性别和病毒血清学与供胰腺获取相关，但与移植无关。供者年龄、死亡原因、脑死亡后捐献状态、终末期血清肌酐和供者区域与供胰腺获取和脑死亡后实体胰腺移植接受均相关，脑死亡后捐献状态是这两种结果的最强预测因素。
在澳大利亚和新西兰，供者年龄、死亡原因、脑死亡后捐献状态、终末期血清肌酐和供者区域与供胰腺获取和随后的移植均相关。这些因素与胰腺移植后结局的后续相关性将有助于指导胰腺移植决策，并最大限度地减少潜在可使用供胰腺的未使用。
