Abstract

Background: Cold ischemia time (CIT) of pancreatic graft is an important factor that influences the results of simultaneous pancreas and kidney transplantation (SPK). The aim of the study is to present logistic methods reducing CIT of pancreatic graft during SPK.
Material/Methods: 32 SPK performed from 2004 to 2008 were analyzed. Lymph nodes (LN) for cross-matching were procured immediately after donor brain death diagnosis. In 12 cases cross-match was done locally (in Katowice) and in 20 - centrally (in the capital of Poland). During LN transport and cross-matching preliminary identification, selection and preparation of 2-3 potential recipients was completed. Finally, selected recipient was sent out to the transplant centre and the transplant team sent out to organ retrieval hospital as soon as the results of the cross-match were obtained.
Results: Mean duration of LN transport and cross-matching was 10 h (identical for local and central typing). Mean duration of recipient's transport to the transplant centre was 2.3 h (0.5 h for local recipients and 3.3h for re-mote recipients). It did not exceed the duration of transplant team's transport and harvesting operation which was 4.7 h (4.3 h for local and 6.8 h for remote retrieval). Mean pancreas CIT was 7.5 h and kidney - 9.1h. 12.5% of patients lost pancreatic graft due to thrombosis. There was no primary kidney graft non-function in the analyzed group.
Conclusions: Early donor lymph nodes procurement for cross-matching as well as early potential recipient's identification, selection and preparation can reduce CIT in SPK.

Keywords: Organ Procurement