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Lookup NU author(s): Dr Sam Tingle, Abdullah Malik, Dr Emily ThompsonORCiD, Dr George KourounisORCiD, Aimen Amer, Sanjay PandanaboyanaORCiD, Professor Colin Wilson, Steven White
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2024 Ho, Tingle, Malik, Thompson, Kourounis, Amer, Pandanaboyana, Wilson and White.Simultaneous pancreas-kidney (SPK) transplantation improves quality of life and limits progression of diabetic complications. There is reluctance to accept pancreata from donors with abnormal blood tests, due to concern of inferior outcomes. We investigated whether donor amylase and liver blood tests (markers of visceral ischaemic injury) predict pancreas graft outcome using the UK Transplant Registry (2016-2021). 857 SPK recipients were included (619 following brainstem death, 238 following circulatory death). Peak donor amylase ranged from 8 to 3300 U/L (median = 70), and this had no impact on pancreas graft survival when adjusting for multiple confounders (aHR = 0.944, 95% CI = 0.754–1.81). Peak alanine transaminases also did not influence pancreas graft survival in multivariable models (aHR = 0.967, 95% CI = 0.848–1.102). Restricted cubic splines were used to assess associations between donor blood tests and pancreas graft survival without assuming linear relationships; these confirmed neither amylase, nor transaminases, significantly impact pancreas transplant outcome. This is the largest, most statistically robust study evaluating donor blood tests and transplant outcome. Provided other factors are acceptable, pancreata from donors with mild or moderately raised amylase and transaminases can be accepted with confidence. The use of pancreas grafts from such donors is therefore a safe, immediate, and simple approach to expand the donor pool to reach increasing demands.
Author(s): Ho NX, Tingle SJ, Malik AK, Thompson ER, Kourounis G, Amer A, Pandanaboyana S, Wilson C, White S
Publication type: Article
Publication status: Published
Journal: Transplant International
Year: 2024
Volume: 37
Online publication date: 20/05/2024
Acceptance date: 07/05/2024
Date deposited: 18/06/2024
ISSN (print): 0934-0874
ISSN (electronic): 1432-2277
Publisher: Frontiers Media SA
URL: https://doi.org/10.3389/ti.2024.12864
DOI: 10.3389/ti.2024.12864
PubMed id: 38832357
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