Evaluation of cadaveric donor usability for pancreas harvesting
and pancreatic islets transplantation in Poland
K Pawelec, J Czerwiński, A Berman, M Wszoła, P Fiedor
Ann Transplant 2009; 14(1): 21-21
Background: Donor shortage is a common problem among all transplant centres. Frequently the acceptance criteria of pancreas for islets isolations are extended to marginal donors. Transplant success rate of islet isolations varies between centres and the ratio is 1/3 to 1/5. Donor status strongly inï¬‚uences islet yield. The clinical Islet Transplantation Programme started in 2008 in Poland, therefore we investigated the potential number of pancreases for islet isolation.
Material/Methods: We analyzed clinical data of 427 effective donors referred to Poltransplant in 2008. Age, ICU stay, treatment with vasoactive drug, hypotension, cardiac arrest, body mass index, glucose and amylase level, past history was analysed. For each variable we allocated points and for each donor total score was calculated (maximal score 75). Applied scoring system was based on literature review and clinical experience.
Results: Of 427 effective donors: 20 (4.7%) became utilised pancreas donors for simultaneous pancreas-kidney procedure. 3 (0.7%) were used for islet isolation (with 1 clinical islet transplantation). Out of remaining 404 donors, 36 had high number of points in the applied score system (over 60) and could be potentially (basing on analysis of clinical risk factors) optimal pancreas donors for islets recovery.
Conclusions: The number of optimal donors that could be allocated for islet isolation should cover the needs of the clinical Islet Transplant Programme. The use of optimal donors should lead to maximize the number of transplantable islet isolations.