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26 July 2019 : Original article  

The Role of Pre-Procurement Pancreas Suitability Score (P-PASS) and Pancreas Donor Risk Index (PDRI) in the Outcome of Simultaneous Pancreas and Kidney or Pancreas After Kidney Transplantation

Clemens Franz1ABCDEFG, Magdalena Görtz12ACDE, Michael Wührl1ACDE, Yakup Kulu1E, Katrin Hoffmann1ACDE, Thilo Hackert1E, Christian Morath3E, Martin Zeier3E, Markus W. Büchler1E, Arianeb Mehrabi1ACD*

DOI: 10.12659/AOT.915852

Ann Transplant 2019; 24:439-445

Abstract

BACKGROUND: The pre-procurement pancreas suitability score (P-PASS) and the pancreas donor risk index (pDRI) are established predictive scores for graft survival and patient outcome following pancreatic transplantation. This retrospective study aimed to evaluate the predictive value of P-PASS and pDRI following simultaneous pancreas and kidney (SPK) transplantation, or pancreas after kidney (PAK) transplantation, and the clinical impact of donor-specific factors on the postoperative graft and recipient outcome at a single transplant center.

MATERIAL AND METHODS: The study included 105 patients who underwent SPK (n=104) or PAK (n=4) between 2000 and 2017. Donor-specific and recipient-specific parameters were recorded. Kaplan-Meier analysis and Cox regression analysis were used to assess the outcome after transplantation.

RESULTS: Overall, the mean 1-year and 5-year pancreas graft survival and patient survival rates were 78.7% and 93.2%, and 76.9% and 90.0%, respectively. The postoperative outcome in patients with a P-PASS score of <17 was not significantly different when compared with patients with a score of ≥17. A P-PASS score of ≥17 was significantly associated with early pancreas graft loss (p=0.04). There was no significant difference in postoperative outcome between patients with high pDRI and low pDRI. Smoking of donor (p=0.046) was a risk factor and coronary heart disease of recipient (p=0.003) had a significant effect on survival of pancreas graft.

CONCLUSIONS: This study showed that P-PASS and pDRI were not reliable predictors of outcome after pancreas transplantation and that specific characteristics of the donor and recipient must be evaluated when predicting the outcome of pancreas transplantation.

Keywords: Graft Survival, Kidney Transplantation, Pancreas Transplantation, Predictive Value of Tests, Middle Aged, Retrospective Studies, Risk Factors, Survival Rate, Tissue Donors

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358