Pancreas donors.

PURPOSE OF REVIEW: Donor issues have a direct impact on the pancreas transplant surgical procedure and play a critical role in the success of the procedure. The purpose of this review is to examine several key donor issues that are likely to have a significant impact on outcomes after pancreas transplant. This review will focus on recent publications dealing specifically with issues related to the pancreas donor.

RECENT FINDINGS: Overall pancreas donors remain underutilized, in the US and in Europe. Only about half of potential pancreas grafts are utilized at present. Concern over the quality of the organ, and the potential risk for surgical complications with extended criteria donor grafts is a major concern. Pancreas grafts from donation after cardiac death donors, for example, provide acceptable results in the long term, but may be associated with a higher incidence of early surgical problems. Risk factors for poor outcome can be identified with the donor that can help in better defining selection criteria, and may help to properly allocate pancreas grafts between whole organ versus islet cell transplantation.

SUMMARY: Proper donor selection and defining donor risk factors plays a critical role in pancreas graft allocation and ultimately the success of the operative procedure.