25 May 2018 : Original article
Usefulness of Pancreas Donor Risk Index and Pre-Procurement Pancreas Allocation Suitability Score: Results of the Polish National Study
Kaja Śmigielska1ABCEF, Paweł Skrzypek2ABCEF, Jarosław Czerwiński34D, Grzegorz Michalak3D, Marek Durlik56B, Tadeusz Grochowiecki1AB, Sławomir Nazarewski1AB, Jacek Szmidt1B, Jacek Ziaja7B, Robert Król7B, Lech Cierpka7B, Wojciech Lisik8ACDFG*, Maciej Kosieradzki8ABCDEFDOI: 10.12659/AOT.909654
Ann Transplant 2018; 23:360-363
Abstract
BACKGROUND: Pre-procurement pancreas suitability score (P-PASS) and pancreas donor risk (PDRI) index are scoring systems believed to predict suitability of pancreatic grafts. Most European countries and the United States apply PDRI, while Poltransplant keeps using P-PASS: more than 16 points raises a red flag for graft use. Recent data discourage use of PDRI to predict pancreas graft survival. The aim of the present study was to assess PDRI and P-PASS as predictors of transplanted pancreas survival in a Polish population.
MATERIAL AND METHODS: From February 1998 to September 2015, 407 pancreas transplantations were performed in Poland: 370 (90.9%) simultaneous pancreas-kidney transplantation and 37 (9.1%) pancreas transplantation alone or pancreas after kidney. The endpoint was death-uncensored 12-month graft survival with satisfactory glycemic control without insulin.
RESULTS: Average P-PASS was 15.9±2.66 and PDRI was 0.96±0.37. Recipients who survived 12 months with good graft function had an average P-PASS score of 15.7 and PDRI of 0.95. Recipients with death-uncensored graft loss had a mean P-PASS of 16.4 and PDRI of 0.99. Univariate analysis revealed donor age, body mass index (BMI), and P-PASS to be significant risk factors for 1-year pancreas graft survival.
CONCLUSIONS: P-PASS, but not PDRI, is a reliable tool to predict pancreas graft survival in the Polish population.
Keywords: Donor Selection, Pancreas Transplantation, Tissue and Organ Procurement
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