Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome

D. L. Dunn, P. Morel, R. Schlumpf, J. L. Mayoral, K. J. Gillingham, K. C. Moudry-Munns, R. A F Krom, Rainer W G Gruessner, W. D. Payne, D. E R Sutherland, J. S. Najarian

Research output: Contribution to journalArticle

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Abstract

We compared outcome after pancreas and liver transplantation when both organs were retrieved from the same donor to outcome when only one or the other organ was retrieved. A total of 166 cadaver pancreata were transplanted at our institution between November 1984 and August 1989 ; 64 were obtained from donors in whom the liver was also donated (LD), and 102 were retrieved from non-liver donors (non-LD). Of the 64 LD pancreata, 53 were the entire organ with a segment of duodenum and 11 were segmental. Both the superior mesenteric artery (SMA) and celiac axis (CA) were retained with the pancreas in 13, while in 40 pancreata the CA was retrieved with the liver and the blood supply to the pancreas was reconstructed [end-to-side anastomosis of splenic artery (SA) to SMA in 11 and a Y-graft of donor iliac bifurcation to SA and SMA in 29]; a graft of common iliac vein was used to extend the portal vein in 10. The technical failure rate was 8/64 (12%) in LD pancreata, and 13/102 (13%) in non-LD pancreata (P>0.1). The overall pancreas allograft survival rate at 1 year was 76% for pancreata obtained from LD (n=64) and 64% for technically successful transplanted pancreata obtained from non-LD (n=102, P>0.1). One-year actuarial patient survival was 95% in the LD group and 90% in the non-LD group (P>0.1). Among the 64 livers from pancreas donors (PD), 20 were transplanted at our hospital, 42 were transported to other institutions, and 2 were not transplanted. Follow-up information regarding 47 primary orthotopic adult, whole liver PD recipients (18 at our hospital, 29 at other institutions) was available for analysis and was compared with information concerning 62 adult recipients of primary orthotopic whole livers from non-PD transplanted during the same period at our institution. The total PNF rate among 47 PD liver allografts was 2/47 (4%), compared with 1/62 (1%) for the livers from non-PD (P>0.1). The technical failure rate for the PD group was 1/47 (2%) versus 5/62 (8%) in the non-PD group (P>0.1). The overall liver allograft survival rate at 1 year was 75% for livers obtained from PD (n=47) and 81% for livers obtained from non-PD (n=62, P>0.1). One-year actuarial patient survival was 88% in the PD group and 81% in the non-PD group (P>0.1). We concluded that simultaneous procurement of liver and pancreas grafts had no significant detrimental effect on the rate of technical failure, or on allograft or patient survival after either pancreas or liver transplantation.

Original languageEnglish (US)
Pages (from-to)150-157
Number of pages8
JournalTransplantation
Volume51
Issue number1
StatePublished - 1991
Externally publishedYes

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Pancreas
Tissue Donors
Transplants
Liver
Superior Mesenteric Artery
Allografts
Splenic Artery
Pancreas Transplantation
Liver Transplantation
Abdomen
Survival
Survival Rate
Iliac Vein
Portal Vein
Duodenum
Cadaver

ASJC Scopus subject areas

  • Immunology
  • Transplantation

Cite this

Dunn, D. L., Morel, P., Schlumpf, R., Mayoral, J. L., Gillingham, K. J., Moudry-Munns, K. C., ... Najarian, J. S. (1991). Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome. Transplantation, 51(1), 150-157.

Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome. / Dunn, D. L.; Morel, P.; Schlumpf, R.; Mayoral, J. L.; Gillingham, K. J.; Moudry-Munns, K. C.; Krom, R. A F; Gruessner, Rainer W G; Payne, W. D.; Sutherland, D. E R; Najarian, J. S.

In: Transplantation, Vol. 51, No. 1, 1991, p. 150-157.

Research output: Contribution to journalArticle

Dunn, DL, Morel, P, Schlumpf, R, Mayoral, JL, Gillingham, KJ, Moudry-Munns, KC, Krom, RAF, Gruessner, RWG, Payne, WD, Sutherland, DER & Najarian, JS 1991, 'Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome', Transplantation, vol. 51, no. 1, pp. 150-157.
Dunn DL, Morel P, Schlumpf R, Mayoral JL, Gillingham KJ, Moudry-Munns KC et al. Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome. Transplantation. 1991;51(1):150-157.
Dunn, D. L. ; Morel, P. ; Schlumpf, R. ; Mayoral, J. L. ; Gillingham, K. J. ; Moudry-Munns, K. C. ; Krom, R. A F ; Gruessner, Rainer W G ; Payne, W. D. ; Sutherland, D. E R ; Najarian, J. S. / Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome. In: Transplantation. 1991 ; Vol. 51, No. 1. pp. 150-157.
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abstract = "We compared outcome after pancreas and liver transplantation when both organs were retrieved from the same donor to outcome when only one or the other organ was retrieved. A total of 166 cadaver pancreata were transplanted at our institution between November 1984 and August 1989 ; 64 were obtained from donors in whom the liver was also donated (LD), and 102 were retrieved from non-liver donors (non-LD). Of the 64 LD pancreata, 53 were the entire organ with a segment of duodenum and 11 were segmental. Both the superior mesenteric artery (SMA) and celiac axis (CA) were retained with the pancreas in 13, while in 40 pancreata the CA was retrieved with the liver and the blood supply to the pancreas was reconstructed [end-to-side anastomosis of splenic artery (SA) to SMA in 11 and a Y-graft of donor iliac bifurcation to SA and SMA in 29]; a graft of common iliac vein was used to extend the portal vein in 10. The technical failure rate was 8/64 (12{\%}) in LD pancreata, and 13/102 (13{\%}) in non-LD pancreata (P>0.1). The overall pancreas allograft survival rate at 1 year was 76{\%} for pancreata obtained from LD (n=64) and 64{\%} for technically successful transplanted pancreata obtained from non-LD (n=102, P>0.1). One-year actuarial patient survival was 95{\%} in the LD group and 90{\%} in the non-LD group (P>0.1). Among the 64 livers from pancreas donors (PD), 20 were transplanted at our hospital, 42 were transported to other institutions, and 2 were not transplanted. Follow-up information regarding 47 primary orthotopic adult, whole liver PD recipients (18 at our hospital, 29 at other institutions) was available for analysis and was compared with information concerning 62 adult recipients of primary orthotopic whole livers from non-PD transplanted during the same period at our institution. The total PNF rate among 47 PD liver allografts was 2/47 (4{\%}), compared with 1/62 (1{\%}) for the livers from non-PD (P>0.1). The technical failure rate for the PD group was 1/47 (2{\%}) versus 5/62 (8{\%}) in the non-PD group (P>0.1). The overall liver allograft survival rate at 1 year was 75{\%} for livers obtained from PD (n=47) and 81{\%} for livers obtained from non-PD (n=62, P>0.1). One-year actuarial patient survival was 88{\%} in the PD group and 81{\%} in the non-PD group (P>0.1). We concluded that simultaneous procurement of liver and pancreas grafts had no significant detrimental effect on the rate of technical failure, or on allograft or patient survival after either pancreas or liver transplantation.",
author = "Dunn, {D. L.} and P. Morel and R. Schlumpf and Mayoral, {J. L.} and Gillingham, {K. J.} and Moudry-Munns, {K. C.} and Krom, {R. A F} and Gruessner, {Rainer W G} and Payne, {W. D.} and Sutherland, {D. E R} and Najarian, {J. S.}",
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T1 - Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome

AU - Dunn, D. L.

AU - Morel, P.

AU - Schlumpf, R.

AU - Mayoral, J. L.

AU - Gillingham, K. J.

AU - Moudry-Munns, K. C.

AU - Krom, R. A F

AU - Gruessner, Rainer W G

AU - Payne, W. D.

AU - Sutherland, D. E R

AU - Najarian, J. S.

PY - 1991

Y1 - 1991

N2 - We compared outcome after pancreas and liver transplantation when both organs were retrieved from the same donor to outcome when only one or the other organ was retrieved. A total of 166 cadaver pancreata were transplanted at our institution between November 1984 and August 1989 ; 64 were obtained from donors in whom the liver was also donated (LD), and 102 were retrieved from non-liver donors (non-LD). Of the 64 LD pancreata, 53 were the entire organ with a segment of duodenum and 11 were segmental. Both the superior mesenteric artery (SMA) and celiac axis (CA) were retained with the pancreas in 13, while in 40 pancreata the CA was retrieved with the liver and the blood supply to the pancreas was reconstructed [end-to-side anastomosis of splenic artery (SA) to SMA in 11 and a Y-graft of donor iliac bifurcation to SA and SMA in 29]; a graft of common iliac vein was used to extend the portal vein in 10. The technical failure rate was 8/64 (12%) in LD pancreata, and 13/102 (13%) in non-LD pancreata (P>0.1). The overall pancreas allograft survival rate at 1 year was 76% for pancreata obtained from LD (n=64) and 64% for technically successful transplanted pancreata obtained from non-LD (n=102, P>0.1). One-year actuarial patient survival was 95% in the LD group and 90% in the non-LD group (P>0.1). Among the 64 livers from pancreas donors (PD), 20 were transplanted at our hospital, 42 were transported to other institutions, and 2 were not transplanted. Follow-up information regarding 47 primary orthotopic adult, whole liver PD recipients (18 at our hospital, 29 at other institutions) was available for analysis and was compared with information concerning 62 adult recipients of primary orthotopic whole livers from non-PD transplanted during the same period at our institution. The total PNF rate among 47 PD liver allografts was 2/47 (4%), compared with 1/62 (1%) for the livers from non-PD (P>0.1). The technical failure rate for the PD group was 1/47 (2%) versus 5/62 (8%) in the non-PD group (P>0.1). The overall liver allograft survival rate at 1 year was 75% for livers obtained from PD (n=47) and 81% for livers obtained from non-PD (n=62, P>0.1). One-year actuarial patient survival was 88% in the PD group and 81% in the non-PD group (P>0.1). We concluded that simultaneous procurement of liver and pancreas grafts had no significant detrimental effect on the rate of technical failure, or on allograft or patient survival after either pancreas or liver transplantation.

AB - We compared outcome after pancreas and liver transplantation when both organs were retrieved from the same donor to outcome when only one or the other organ was retrieved. A total of 166 cadaver pancreata were transplanted at our institution between November 1984 and August 1989 ; 64 were obtained from donors in whom the liver was also donated (LD), and 102 were retrieved from non-liver donors (non-LD). Of the 64 LD pancreata, 53 were the entire organ with a segment of duodenum and 11 were segmental. Both the superior mesenteric artery (SMA) and celiac axis (CA) were retained with the pancreas in 13, while in 40 pancreata the CA was retrieved with the liver and the blood supply to the pancreas was reconstructed [end-to-side anastomosis of splenic artery (SA) to SMA in 11 and a Y-graft of donor iliac bifurcation to SA and SMA in 29]; a graft of common iliac vein was used to extend the portal vein in 10. The technical failure rate was 8/64 (12%) in LD pancreata, and 13/102 (13%) in non-LD pancreata (P>0.1). The overall pancreas allograft survival rate at 1 year was 76% for pancreata obtained from LD (n=64) and 64% for technically successful transplanted pancreata obtained from non-LD (n=102, P>0.1). One-year actuarial patient survival was 95% in the LD group and 90% in the non-LD group (P>0.1). Among the 64 livers from pancreas donors (PD), 20 were transplanted at our hospital, 42 were transported to other institutions, and 2 were not transplanted. Follow-up information regarding 47 primary orthotopic adult, whole liver PD recipients (18 at our hospital, 29 at other institutions) was available for analysis and was compared with information concerning 62 adult recipients of primary orthotopic whole livers from non-PD transplanted during the same period at our institution. The total PNF rate among 47 PD liver allografts was 2/47 (4%), compared with 1/62 (1%) for the livers from non-PD (P>0.1). The technical failure rate for the PD group was 1/47 (2%) versus 5/62 (8%) in the non-PD group (P>0.1). The overall liver allograft survival rate at 1 year was 75% for livers obtained from PD (n=47) and 81% for livers obtained from non-PD (n=62, P>0.1). One-year actuarial patient survival was 88% in the PD group and 81% in the non-PD group (P>0.1). We concluded that simultaneous procurement of liver and pancreas grafts had no significant detrimental effect on the rate of technical failure, or on allograft or patient survival after either pancreas or liver transplantation.

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