Impact of Preprocurement Cardiac Arrest in Brain-Dead Donors on the Outcome of Pancreas Transplantation.

Transplantation proceedings Pub Date : 2024-12-01 Epub Date: 2024-11-27 DOI:10.1016/j.transproceed.2024.11.011
Minyan Zheng, Yue Wu, Jie Xiang, Li Wang, Zhiwei Li, Feng Gao
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Abstract

Background: This study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes.

Methods: We 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.

Results: There were 1129 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 = .010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02-1.04; P =.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 = .018 and P = .014, respectively), which were comparable (log-rank P = .711). No relationships were found among the various transplantation types.

Conclusions: CA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.

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脑死亡供体获取前心脏骤停对胰腺移植结果的影响。
背景:本研究旨在确定脑死亡供体(DBD)的危险因素和心脏骤停(CA)是否会影响胰腺移植结果。方法:我们分析了移植受者科学登记处(2000-2020)的数据。本研究纳入21499例胰腺移植,根据患者是否有ca病史分为CA-DBD组和noCA-DBD组。结果:CA-DBD移植1129例(5.3%)。两组的主要供体死亡原因都是头部创伤。两组的移植物和患者存活率相似。在单因素分析中,CA时间(CAT)是胰腺移植存活的危险因素(风险比[HR], 1.05;95%置信区间[CI], 1.03-1.08;P = 0.010)和多因素Cox回归模型(HR, 1.03;95% ci, 1.02-1.04;P = .015)。CAT≥30分钟的胰腺移植存活率明显低于CAT患者。结论:供体CA不影响胰腺移植预后。然而,CAT≥30分钟的胰腺供者应仔细评估。
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