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Pancreas transplants from donors aged 45 years or older.

Abstract：

AIMS:Since donor age of 45 years or more is considered a relative contraindication for pancreas transplantation (PTx), we herein report our experience with these donors. METHODS:Pancreases from donors aged 45 years or older were used in 16 of 147 PTx procedures (11%). The final decision to accept a graft for PTx was based mainly on the quality of visceral perfusion and the gross appearance of the pancreas and the vessels. There were 9 men and 7 women, ranging in age from 45 to 55 years (average, 48.9 years) who were donors, due to cerebrovascular accidents (n = 11; 68.7%). Among the donor group, 5 patients were receiving multiple vasopressor agents (31.2%), and 2 had a history of cardiac arrest (12.5%). Pancreases were transplanted either simultaneously with a cadaveric kidney (n = 6) or as solitary grafts (n = 10). RESULTS:After a mean period of cold preservation of 616 minutes (range, 475 to 844 min), delayed endocrine function occurred in 1 recipient (6%), who subsequently achieved insulin independence. Two recipients died suddenly, with functioning grafts. Two further grafts were lost due to portal vein thrombosis (6%) or late arterial thrombosis (6%). Three patients required repeat surgery (18.7%). After a mean follow-up period of 26.6 months, actuarial 1-year and 5-year patient survival rates were 87.5%, with insulin independence in 81.2% and 67.7%, respectively. CONCLUSIONS:Meticulous donor selection and short preservation times allow the safe use of pancreases procured from donors aged 45 years or older, thus expanding the donor pool for PTx procedures.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Boggi U,Del Chiaro M,Signori S,Vistoli F,Amorese G,Croce C,Morelli L,Vanadia Bartolo T,Pietrabissa A,Barsotti M,Rizzo G,Mosca F

doi

10.1016/j.transproceed.2005.01.027

subject

Has Abstract

pub_date

2005-03-01 00:00:00

pages

1265-7

issue

2

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(05)00034-5

journal_volume

37

pub_type

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