Table 1.
Cold ischemia time and association with clinical outcomes in pancreas transplantation.
| Reference | Number of Patients/Time Period/Country | Outcome Considered | Type of Donor | Incidence of Technical Failure and Thrombosis | CIT Time Considered | Results | Other Variables Associated with Outcome |
|---|---|---|---|---|---|---|---|
| Axelrod et al. [11] | 9401 patients 2000–2006 SRTR (USA) |
1-year graft survival (development of pancreas donor risk index (PDRI)) |
DBD and DCD (1.4 %) | Preservation time > 12 h associated with outcome, integrated in PDRI | |||
| Öllinger et al. [17] | 509 patients 1979–2011 Austria |
Long-term graft survival | DBD | Thrombosis cause of 6.5% of pancreas losses | Continuous variable | CIT > 14 h associated with worse 10-year graft survival (44% vs. 65%, p = 0.04) but not in multivariate analysis | Donor age Type of transplantation Time of transplantation Number of transplants |
| Finger et al. [10] | 1115 patients 1998–2011 USA |
Technical failure (graft loss <90 days due to thrombosis, bleeding, pancreatitis or intra-abdominal infections). | DBD and DCD (2.9%) | Incidence of TF 10.2% Incidence of thrombosis 5.6% | Cut-off 20h | Multivariate model preservation time >20 h associated with TF (HR 2.17 [1.45;3.23], p < 0.001) | Donor BMI Donor Cr Donor age |
| Kopp et al. [16] | 349 patients 1984–2012 Netherlands |
Pancreas allograft survival | DBD and DCD (2%) | Early graft failure (<3 months) due to technical failure 9.4%, including thrombosis (8.3 % of total graft failure) | Continuous variable | Death-censored pancreas allograft associated with CIT (p = 0.005) Pancreas graft survival multivariate model CIT HR 0.9 [0.81–0.99], p = 0.033 |
Transplant type (SPK vs. PTA/PAK) Procurement center local/non-local Recipient cerebrovascular disease |
| Mittal et al. [12] | 1201 patients 2004–2011 UK |
1-year graft survival | DBD and DCD (10.8%) | Continuous variable | Cold ischemia time associated with outcome (p < 0.001) | PDRI | |
| Gruessner et al. [6] | 11 104 2005–2014 World (UNOS/IPTR) |
Allograft survival Technical failure Graft thrombosis |
DBD and DCD (3% of SPK) | Early TF (<3 months) 7.4% for 2005–2009 era and 5.4% for 2010-2014 (SPK) Thrombosis 5.5% for 2005-2009 era and 4.1% for 2010–2014 (SPK) |
Cut-offs 12h and 24h | Preservation time associated with pancreas failure (SPK) (RR 12 h–24 h 1.18 [1.06;1.33], >=24 h 2.38 [1.60;3.53], vs. 0–11 h, p < 0.0001, multivariate analysis) Preservation time associated with early graft failure due to graft thrombosis (SPK) (RR 12h-24h 1.18 [0.94;1.49], >=24 h 3.14 [1.51;6.51], vs. 0–11h, p = 0.005 multivariate analysis) |
Allograft failure (SPK) Era Recipient gender Recipient BMI PRA Donor age Donor Cause of death Immunosuppression Center volume Early graft failure due to thrombosis (SPK) Era Recipient BMI PRA Donor cause of death |
HR hazard ratio, RR relative risk, Cr creatinine, BMI body mass index, CIT cold ischemia time, TF transplant failure, DBD donation after Brain death, DCD donation after cardiac death, SRTR scientific registry of transplant recipients, PDRI pancreas donor risk index, UNOS united network for organ sharing, IPTR international pancreas transplant registry, SPK simultaneous pancreas and kidney transplantation.