Pancreas Transplantation from pediatric donors: a single center experience

Background Pancreas allografts from pediatric donors are considered less suitable due to the increased risk of surgical complications and reduced islet cell mass that may compromise function. Methods All pancreatic transplants, procured from donors 60kg. Analysis of patient and graft survival was done between the groups, and subsequently between the pediatric cohort and the adult-donor control group. Results Sixty-three pediatric-donor pancreas transplants were performed. The mean donor age and weight were of 12.10±4.13 years and 47.8±21.3kg. Excellent metabolic control was achieved in 59 (93.65%) patients at the time of discharge and at a mean 5 year follow up, with the average hemoglobin A1c of 5.30 ±0.61% and blood glucose level of 102.75±20.70 mg/dL in those with a functioning graft. Nine graft losses were registered, of which one (1.6%) was due to arterial thrombosis. Eight (12.7%) patients experienced rejection. Overall graft survival and patient survival were of 85.7% and 92.1%, respectively, at a median follow up of 37.07 months (min 0.19 – max 119.57). No differences amongst the 3 groups were identified. Long term patient and allograft survival was comparable to that of the adult-donor pancreatic transplants. Conclusion Pediatric-donor pancreas demonstrated excellent short-term outcomes with no surgical complications and promising long-term outcomes despite the smaller islet mass. Pancreata from pediatric donors should not be marginalized and can offset worsening organ shortage. Corresponding Author: Mario Spaggiari, MD, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Clinical Sciences Building, Suite 522, Chicago, Illinois 60612. Telephone: 312-996-6771. Fax: 312-413-3483. mspaggia@uic.edu Authorship: Mario Spaggiari participated in study design, statistical analysis, and writing. The author declares no conflict of interest. Caterina Di Bella participated in study design, statistical analysis, and writing. The author declares no conflict of interest. Pierpaolo Di Cocco participated in study design, statistical analysis and writing. The author declares no conflict of interest. Maya Campara participated in writing and critical review. The author declares no conflict of interest. Kelly Galen participated in writing and critical review. The author declares no conflict of interest Federico Gheza participated in data analysis and critical review. The author declares no conflict of interest. Jose Oberholzer participated in critical review and study design. The author declares no conflict of interest. Enrico Benedetti participated in critical review and study design. The author declares no conflict of interest. Ivo G. Tzvetanov participated in critical review and study design. The author declares no conflict of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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