Introduction: Normothermic regional perfusion (NRP) in donation after circulatory death (DCD) donors restores an oxygenated circulation to the abdominal organs for 2 hours before in situ cold perfusion. We evaluated the outcomes of DCD pancreases undergoing this treatment with a contemporaneous cohort of DCD and DBD pancreas transplants.
Methods: The records of all recipients of DCD and DBD SPK transplants since the introduction of NRP were reviewed.
Results: Between March 2013 and August 2016,9 patients have undergone an SPK transplant from a donor who underwent NRP at retrieval; these were compared with 22 non-NRP DCD SPK transplants and 55 DBD SPK transplants in the same period, and followed up until 1/2/2017. All patients received the same immuno­suppressive protocol. The table illustrates the difference in outcomes. 

There were no deaths in either DCD group and no kidneys were lost; there was a single death following DBD SPK transplantation and one kidney lost. In the NRP group the single pancreas loss was due to early graft thrombosis; in the standard DCD group the graft that was lost had undergone a partially successful portal vein thrombectomy early post transplant but eventually failed at 140 days.
Discussion: The NRP DCD SPK group involved the youngest donors and recipients, with more recipients pre-dialysis at the time of transplant. In spite of that these initial data show no benefit of NRP for patients undergoing SPK transplantation.  The results from DCD SPK transplants are similar to DBD SPK transplants.