Abstract / Summary
Abstract Increased use of donation after circulatory death (DCD) organs can lessen the ongoing organ shortage in transplantation. While DCD donor utilization has increased in other types of organ transplantation, with outcomes comparable to donation after brain death (DBD) donors, DCD use in pancreas transplantation is declining. To rigorously define the risk of DCD pancreas donors and control for confounding variables, we performed a propensity score-matched analysis of adult simultaneous pancreas-kidney (SPK) transplantations. Using data from the Organ Procurement and Transplantation Network (OPTN) registry, we examined 1036 propensity-matched pancreas transplant recipients of 777 DBD and 259 DCD donor organs between 2010 and 2022. In univariable Cox proportional hazards models fitted in the propensity score-matched cohort, with robust variance estimates clustered by matched set, SPK recipients of DCD donors had post-transplant patient and graft survival outcomes comparable to those of DBD donors at 1 and 3 years. DCD recipients experienced similar rates of treatment for graft rejection at 6 months and 1 year, comparable rates of postoperative complications, and similar renal function at 1 year compared with DBD recipients. SPK recipients of DCD donors benefited from significantly shorter wait times for organs than recipients of DBD donors. The use of DCD donors in pancreas transplantation can safely increase organ availability.