Outcomes of pancreas allografts retrieved simultaneously with an isolated intestine allograft: Single center and national data

J.A. Fridell, R.S. Mangus, R.M. Vianna, A.J. Tector, J.A. Powelson
Indiana University School of Medicine, Surgery, Indianapolis, USA

Background: Simultaneous procurement of a pancreas and isolated intestine allograft from the same donor may compromise one or both grafts given their shared vasculature. This study reports the outcomes for pancreas allografts procured simultaneously with an intestine. Separate analyses are reported from (1) a single center and (2) 10-year national data from the UNOS database. SRTR reference data for all pancreas grafts are provided for comparison.

Methods: Local, single center data were reviewed retrospectively for all donors with simultaneous pancreas and isolated intestine procurement. U.S.A. national data were obtained from UNOS, and included all donors from 2000 to 2010 in which both the pancreas and isolated intestine were retrieved and transplanted into separate recipients.

Results: There were 27 isolated intestine allografts procured at our center during the study period. There were 11 cases (41%) in which the pancreas was transplanted. The reasons for non-transplantation of the pancreas in the other 16 donors included donor age (n=10), graft quality (n=4), and anatomic or surgical issues (n=2). For the 11 transplanted grafts, 1-year pancreas allograft survival was 100%. Nationally, there were 159 simultaneous pancreas and intestine donors. Graft and patient survival were acceptable when compared to SRTR reference outcomes for all U.S. pancreas transplants (Table).

Conclusions: These results suggest that pancreas allografts procured simultaneously with an intestine, although technically more demanding, do not have significantly inferior survival outcomes compared to pancreas allografts procured without intestinal retrieval.