Simultaneous pancreas-kidney transplantation from donation after cardiac death - Successful long-term outcomes

Objective: The outcomes of simultaneous pancreas-kidney (SPK) transplantation with donor organs procured from donation after cardiac death (DCD) are compared with transplants performed with donor organs recovered from donation after brain death (DBD). Summary Background Data: Concerns exist regarding the utilization of pancreata obtained from DCD donors. While it is known that DCD kidneys will have a higher rate of DGF, long-term functional graft survival data for DCD pancreata have not been reported. Methods: A retrospective review of all DCD SPK transplants performed at a single center was undertaken. Results: Patient, pancreas, and kidney survival at 5 years were similar between DCD and DBD organs. Pancreas function and outcomes were indistinguishable between the 2 modes of procurement. As expected, the DCD kidneys had an elevated rate of DGF, which had no significant long-term clinical impact. Conclusion: SPK transplantation using selected DCD donors is a safe and viable method to expand the organ pool for transplantation.