Elsevier

Transplantation Proceedings

Volume 48, Issue 9, November 2016, Pages 3037-3039
Transplantation Proceedings

4th Congress of the Spanish Society of Transplantation
Pancreas transplantation
Validation of the Pancreatic Donor Risk Index in Simultaneous Pancreas-Kidney Transplantation Performed in Córdoba Hospital From 2000 to 2015

https://doi.org/10.1016/j.transproceed.2016.07.049Get rights and content

Highlights

  • There are demographic differences in donor pancreas profiles between different populations.

  • The PDRI was not a suitable predictor of graft survival in our series.

  • Except for cold ischemia time, the factors proposed by the PDRI were not superimposable to our study population.

Abstract

Background

The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015.

Methods

This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015. Donor variables that are integrated in the PDRI were calculated (age, sex, race, creatinine serum levels, body mass index, height, cold ischemia time, cause of death, type of pancreas transplant). Pancreatic graft survival at 1 and 5 years was calculated by use of the Kaplan-Meier test. Comparison of survival curves between PDRI risk quartiles was calculated by use of the log-rank test. Association between graft survival and variables integrating the PDRI was calculated by use of univariate Cox regression analysis.

Results

Log-rank analysis found no statistically significant association between global graft survival and PDRI quartiles. Univariate Cox regression analysis showed a statistically significant association between graft survival and cold ischemia time (P < .05).

Conclusions

PDRI was not a useful tool to predict pancreatic graft outcomes in a Spanish reference population.

Section snippets

Methods

This was a retrospective analysis of a registry of a total of 126 SPK performed by the same surgical team in our center between the years 2000 and 2015. Patients were excluded if there were insufficient data for calculating the PDRI or loss of patient control. Eight cases were excluded from final analysis. There were no cases of donation after cardiac death.

The PDRI was calculated for all pancreas grafts through the original model proposed by Axelrod et al. We used the “Pancreas Transplant

Demographics

The mean PDRI was 1.08 (±0.31), and it ranged from 0.70 to 2.00. No case was in the highest PDRI quartile (2.12–2.86). Data from the donor cohort, logistic characteristics of the procedure, and calculated PDRI are shown in Table 1.

PDRI and Graft Survival

One-year global cumulative survival in the series was 87%. Figure 1 shows graft survival curves according to PDRI groups. One-year graft survival for lowest- to high-risk PDRI quartiles calculated by use of the Kaplan-Meier test were 92%, 88%, 85%, and 75%,

Discussion

The aim of pancreas transplantation is to improve patient survival and quality of life by minimizing the severe risks that may be associated with the procedure [8], [9]. In the current situation, in which graft demand continues to grow, a successful transplant system is based on the correct selection and distribution of available organs. In that sense, several groups have designed a model that uses data of transplant donors, to provide risks and guide organ utilization before transplantation

Conclusions

In our series, the PDRI could not be validated as a predictor of pancreatic graft outcomes after SPK.

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