Who needs a pancreas donor risk index?

Berney, Thierry; Kandaswamy, Raja

doi:10.1111/tri.12599

Cited by 3 publications

(3 citation statements)

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“…Furthermore, countries with a lower mean PDRI donor that also have increasing waiting lists and increased waiting time until transplantation might utilize a more aggressive approach by accepting higher risk donors. Therefore, to answer the question on the usefulness of these donor risk indices raised by Berney and Kandaswamy in a recent commentary in Transplant International , a donor risk index, such as the PDRI, can be helpful in proper donor selection, but also in describing a certain donor population to compare center or country specific outcome .…”

Section: Discussionmentioning

confidence: 99%

Donor risk indices in pancreas allocation in the Eurotransplant region

et al. 2016

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SUMMARYPancreas donor selection and recognition are important to cope with increasing organ shortage. We aim to show that the PDRI is more useful than the P-PASS to predict acceptance and should thus be preferred over P-PASS. Eurotransplant donors from 2004 until 2014 were included in this study. PDRI logistical factors were set to reference to purely reflect donor quality (PDRI donor ). PDRI and P-PASS association with allocation outcome was studied using area under the receiver operating characteristic curve (AUROC). Regional differences in donor quality were also investigated. Of the 10 444 pancreata that were reported, 6090 (58.3%) were accepted and 2947 (28.2%) were transplanted. We found that P-PASS was inferior to PDRI donor in its ability to predict organ reporting, acceptance, and transplantation: AUC 0.63, 0.67 and 0.73 for P-PASS vs. 0.78, 0.79 and 0.84 for PDRI donor , respectively. Furthermore, there were significant differences in donor quality among different Eurotransplant countries, both in reported donors and in transplanted organs. PDRI is a powerful predictor of allocation outcome and should be preferred over P-PASS. Proper donor selection and recognition, and possibly a more liberal approach toward inferior quality donors, may increase donation and transplant rates. Transplant International 2016; 29: 921-929

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Section: Discussionmentioning

confidence: 99%

Donor risk indices in pancreas allocation in the Eurotransplant region

et al. 2016

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“…In their study, Lam et al . showed that pancreases procured by certified surgeons presented fewer injuries and were more frequently transplanted, despite more challenging procurements in the certified surgeon group. Although some reported improvements in the certified group were short of statistical evidence, it is obvious that such a policy improved the overall pancreas transplantability.…”

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confidence: 97%

“… Technical mistakes because of the lack of experience can be the source of parenchymal or vascular injuries. Excessive manipulation by an unexperienced training surgeon may increase the risk of ischemic/reperfusion injury and technical failure. For the procuring team, in case of uncertainty about the transplantability of the pancreas, risk aversion attitudes may lead to turning down a suitable organ . Even if the pancreas can be assessed on the backtable, part of the assessment should be performed in the donor (color, fatty infiltration, presence of other nonsurgical injuries of the retroperitoneum, etc.…”

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confidence: 99%