Pancreas transplantation from marginal donors

BACKGROUND: Marginal donor organs are a supplementary source of grafts that has not been fully exploited for pancreas transplantation (PTx). METHODS: A total of 100 PTx were performed with grafts procured from either 48 nonmarginal donors (NMD) or 52 marginal donors (MD), namely age greater than 45 years and/or severe hemodynamic instability at the time of procurement. PTx outcome was evaluated as the incidence of delayed endocrine pancreas function (DEPF), the complication rate, and the patient and graft survivals. RESULTS: The DEPF rate was 6.2% for NMD as compared to 0 for MD (P >.05). Relaparotomy rate was 12.5% for NMD and 9.6% for MD (P >.05). Actuarial 1-year graft survival was 91.7% and 94.2% for NMD and MD, respectively (P >.05). Equivalent figures for patients were 97.9% and 98.1%, respectively (P >.05). CONCLUSIONS: Pancreas from MD may be safely employed and significantly expand the donor pool for PTx.