Impact of Pre-Procurement Cardiac Arrest in Brain-Dead Donors on the Outcome of Pancreas Transplantation

Abstract

BackgroundThis study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes. MethodsWe analyzed data from the Scientific Registry of Transplant Recipients (2000-2020). The study included 21,499 pancreas transplantations, divided into CA-DBD and noCA-DBD groups based on whether the DBD had a history of CA. ResultsThere were 1,129 CA-DBD (5.3%) transplantations. The principal donor death cause for both groups was head trauma. Graft and patient survival rates were similar in both groups. CA time (CAT) was a risk factor for pancreatic graft survival in the univariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03–1.08; P = 0.010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02–1.04; P = 0.015). Pancreas graft survival in those with CAT ≥30 minutes was significantly lower than in those with CAT <30 minutes and the noCA-DBD group (log-rank P = 0.018 and P = 0.014, respectively), which were comparable (log-rank P = 0.711). No relationships were found among the various transplantation types. ConclusionsCA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.