P-154

10 years of simultaneous pancreas/kidney transplantation – a retrospective single center analysis of prospectively obtained data

D. Foltys, M. Heise, M. Hoppe-Lotichius, G. Otto
University Medical Center Mainz, Transplant Surgery, Mainz, Germany

Introduction When suffering from both diabetes mellitus and end stage renal disease, combined pancreas-kidney transplantation (PKT) is a standardized and lifesaving procedure. With the pre-procurement pancreas suitability scoring system (P-PASS), Eurotransplant has developed a tool to identify ideal donors with a value of <17. In an effort to expand the German donor pool, marginal donor organs are gladly accepted. In order to better determine organ survival,we proceeded to retrospectively analyze our data on all PKTx in accordance with P-PASS.

Methods From 1999 to 2010 fifty-five recipients of PKTx were analysed. Fifty-three patients were suffering from diabetes mellitus Type I, two patients were pancreoprivic. All transplantations were performed using systemic-enteric drainage. The immunosuppressive protocol includes induction therapy with Basiliximab and maintenance therapy using Tacrolimus, Mycophenolate Mofetil and steroids.

Results The overall survival rate after 5 five years was 83%, after 10 years 78%. Organ survival of the pancreas was 74% after one year, 59% after 5 years and 53% after 10 years. Three patients needed re-transplantation of PKTx and 6 patients needed singular pancreas re-transplantation. Seventeen patients showed acute rejection episodes and 14 patients suffered from CMV infection. We compared 41 patients receiving organs from an “ideal” donor (P-PASS<17) to 12 patients with grafts from marginal donors (P-PASS ≥17). Neither P-PASS nor donor age demonstrated significant influence on organ survival. However, BMI showed a negative tendency (p=0,059).

Conclusion In this retrospective single -center analysis of prospectively obtained data after PKTx, the P-PASS showed no significant prediction of either overall patient survival, pancreas graft survival or pancreas-related postoperative morbidity. In view of our data, the expansion of the German donor pool is possible, probable and paramount. A multicenter study of PKTx using marginal donors is mandatory to evaluate our results and to define the realistic “cut off” level of P-PASS.

P-154

10 years of simultaneous pancreas/kidney transplantation – a retrospective single center analysis of prospectively obtained data

D. Foltys, M. Heise, M. Hoppe-Lotichius, G. Otto
University Medical Center Mainz, Transplant Surgery, Mainz, Germany

Introduction When suffering from both diabetes mellitus and end stage renal disease, combined pancreas-kidney transplantation (PKT) is a standardized and lifesaving procedure. With the pre-procurement pancreas suitability scoring system (P-PASS), Eurotransplant has developed a tool to identify ideal donors with a value of <17. In an effort to expand the German donor pool, marginal donor organs are gladly accepted. In order to better determine organ survival,we proceeded to retrospectively analyze our data on all PKTx in accordance with P-PASS.

Methods From 1999 to 2010 fifty-five recipients of PKTx were analysed. Fifty-three patients were suffering from diabetes mellitus Type I, two patients were pancreoprivic. All transplantations were performed using systemic-enteric drainage. The immunosuppressive protocol includes induction therapy with Basiliximab and maintenance therapy using Tacrolimus, Mycophenolate Mofetil and steroids.

Results The overall survival rate after 5 five years was 83%, after 10 years 78%. Organ survival of the pancreas was 74% after one year, 59% after 5 years and 53% after 10 years. Three patients needed re-transplantation of PKTx and 6 patients needed singular pancreas re-transplantation. Seventeen patients showed acute rejection episodes and 14 patients suffered from CMV infection. We compared 41 patients receiving organs from an “ideal” donor (P-PASS<17) to 12 patients with grafts from marginal donors (P-PASS ≥17). Neither P-PASS nor donor age demonstrated significant influence on organ survival. However, BMI showed a negative tendency (p=0,059).

Conclusion In this retrospective single -center analysis of prospectively obtained data after PKTx, the P-PASS showed no significant prediction of either overall patient survival, pancreas graft survival or pancreas-related postoperative morbidity. In view of our data, the expansion of the German donor pool is possible, probable and paramount. A multicenter study of PKTx using marginal donors is mandatory to evaluate our results and to define the realistic “cut off” level of P-PASS.