Pancreas Survival For Transplantation From Donors With Hypertension

BackgroundThe increasing morbidity of diabetes followed by the rising demands for pancreas transplantation.To extend the donor pool,surgeons have been focusing on the marginal donors,and trying to set up a more appropriate assessment system.Objective:We aim to compare the overall survival and graft survival rates of the recipients who receive the organ from hypertension donors and the others,thus evaluate the effect of donor hypertension.MethodsThere were 24192 pancreas transplantation patients from the Scientilic Registry of Transplant Recipients database evolved in this analysis,which were divided into hypertension group(HTN,n=1531)and non-hypertension group(non-HTN,n=22,661)according to the hypertension status of donors.All variables of donors and recipients were analyzed by t test for continuous variables and chi-square test for categorical variables.Recipient overall and graft survival were analyzed and compared by log rank test,and Cox proportional hazard models was used to evaluate the hazard ratios of predictors.ResultsPatient overall and graft survival of non-HTN group were higher than those of the HTN group(both p<0.001).And the decreased recipient overall and graft survival rates were accompanied by the longer duration of donor hypertension history(both p<0.001).Multivariate analyses demonstrated that hypertension was an independent factor for reduced survival(hazard ratio[HR],1.10;95%confidence interval[CI],1.01-1.18;p<0.001).Other independent factors included recipient body mass index(HR,1.02;95%CI,1.01-1.05;p<0.001)and transplant type(pancreas after kidney transplants/pancreas transplant alone vs.simultaneous pancreas-kidney transplants;HR,1.41;95%CI,134-1.55;p<0.001).ConclusionBesides the type of transplants and BMI,donor hypertension is an independent factor for recipient overall and graft survival post-transplants,which should be considered in donor evaluation and help post-transplant surveillance in clinical practice.