Zheng Minyan, Wu Yue, Xiang Jie, Wang Li, Li Zhiwei, Gao Feng
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Urological Surgery, Weifang People's Hospital, Shandong, China.
Transplant Proc. 2024 Dec;56(10):2255-2262. doi: 10.1016/j.transproceed.2024.11.011. Epub 2024 Nov 27.
This study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes.
We analyzed data from the Scientific Registry of Transplant Recipients (2000-2020). The study included 21,499 pancreas transplantations, divided into CA-DBD and noCA-DBD groups based on whether the DBD had a history of CA.
There were 1129 CA-DBD (5.3%) transplantations. The principal donor death cause for both groups was head trauma. Graft and patient survival rates were similar in both groups. CA time (CAT) was a risk factor for pancreatic graft survival in the univariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; P = .010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02-1.04; P =.015). Pancreas graft survival in those with CAT ≥30 minutes was significantly lower than in those with CAT <30 minutes and the noCA-DBD group (log-rank P = .018 and P = .014, respectively), which were comparable (log-rank P = .711). No relationships were found among the various transplantation types.
CA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.
本研究旨在确定脑死亡供体（DBD）发生心脏骤停（CA）的危险因素，以及CA是否会影响胰腺移植的结果。
我们分析了移植受者科学登记处（2000 - 2020年）的数据。该研究纳入了21499例胰腺移植，根据DBD是否有CA病史分为CA - DBD组和无CA - DBD组。
有1129例（5.3%）为CA - DBD移植。两组供体的主要死亡原因均为头部外伤。两组的移植物和患者生存率相似。在单因素分析中，心脏骤停时间（CAT）是胰腺移植物存活的危险因素（风险比[HR]，1.05；95%置信区间[CI]，1.03 - 1.08；P = 0.010），在多因素Cox回归模型中也是如此（HR，1.03；95% CI，1.02 - 1.04；P = 0.015）。CAT≥30分钟者的胰腺移植物存活率显著低于CAT<30分钟者和无CA - DBD组（对数秩检验P分别为0.018和0.014），而后两者具有可比性（对数秩检验P = 0.711）。未发现不同移植类型之间存在关联。
供体发生CA不影响胰腺移植物的预后。然而，对于CAT≥30分钟的胰腺供体应进行细致评估。
