Usefulness of Pancreas Donor Risk Index and Pre-Procurement Pancreas Allocation Suitability Score: Results of the Polish National Study
Kaja Śmigielska, Paweł Skrzypek, Jarosław Czerwiński, Grzegorz Michalak, Marek Durlik, Tadeusz Grochowiecki, Sławomir Nazarewski, Jacek Szmidt, Jacek Ziaja, Robert Król, Lech Cierpka, Wojciech Lisik, Maciej Kosieradzki
(Department of General, Vascular and Transplantation Surgery, The Medical University of Warsaw, Warsaw, Poland)
Ann Transplant 2018; 23:360-363
Pre-procurement pancreas suitability score (P-PASS) and pancreas donor risk (PDRI) index are scoring systems believed to predict suitability of pancreatic grafts. Most European countries and the United States apply PDRI, while Poltransplant keeps using P-PASS: more than 16 points raises a red flag for graft use. Recent data discourage use of PDRI to predict pancreas graft survival. The aim of the present study was to assess PDRI and P-PASS as predictors of transplanted pancreas survival in a Polish population.
MATERIAL AND METHODS: From February 1998 to September 2015, 407 pancreas transplantations were performed in Poland: 370 (90.9%) simultaneous pancreas-kidney transplantation and 37 (9.1%) pancreas transplantation alone or pancreas after kidney. The endpoint was death-uncensored 12-month graft survival with satisfactory glycemic control without insulin.
RESULTS: Average P-PASS was 15.9±2.66 and PDRI was 0.96±0.37. Recipients who survived 12 months with good graft function had an average P-PASS score of 15.7 and PDRI of 0.95. Recipients with death-uncensored graft loss had a mean P-PASS of 16.4 and PDRI of 0.99. Univariate analysis revealed donor age, body mass index (BMI), and P-PASS to be significant risk factors for 1-year pancreas graft survival.
CONCLUSIONS: P-PASS, but not PDRI, is a reliable tool to predict pancreas graft survival in the Polish population.
Keywords: Donor Selection, Pancreas Transplantation, Tissue and Organ Procurement