Report from the Japan Registry of Pancreas Transplantation (2000-2012): outcomes of pancreas transplantation from marginal donors.

One hundred forty-eight pancreas transplants [119 simultaneous pancreas and kidney transplantations (SPK), 20 pancreas after kidney transplantations, 9 pancreas transplants alone] from deceased donors were performed in Japan during the period from 2000 to 2012. According to Kapur's criteria, 108 out of 148 (73.0%) cases involved marginal donors. Of importance, when total cold ischemic time was more than 12 hours, early pancreas graft loss (first 3 months posttransplantation) significantly increased. Other donor-related risk factors such as donor age, obesity, cause of death, and marginality did not influence early graft loss. The overall outcome of pancreas transplant in our series was comparable to that of United States and Europe. The patient survival rate was 94.8% at 1, 3, and 5 years. Pancreas graft survival rates were 84.8%, 76.4%, and 68.9% at 1, 3, and 5 years, respectively. For SPK, kidney graft survival rates were 90.2%, 90.2%, and 82.8%, at 1, 3, and 5 years, respectively. Moving forward, further investigation will be necessary to determine which risk factors in marginal donors will be important.