MULTIVARIATE-ANALYSIS OF DONOR RISK-FACTORS FOR PANCREAS ALLOGRAFT FAILURE AFTER SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION

Background. Donor and recipient selection criteria for pancreas allogr aft are not standardized and may vary from center to center. Methods. Simultaneous pancreas-kidney transplantations performed between April 1988 and June 1994 were reviewed (n = 61), and univariate and multivar iate analyses of factors that affect pancreas graft survival were perf ormed. Analysis of all cases and cases excluding early thrombosis were performed separately. Results. Pancreas graft survival when early thr ombosis was excluded and in the overall group was 76% and 70%, respect ively, at 1 year. Although blood group and donor gender were weak pred ictors of graft survival by univariate analysis, neither affected graf t survival in the multivariate model. Risk factors for graft failure a s determined by Cox regression analysis and in descending order of sig nificance were (1) duration of brain death before procurement, (2) len gth of donor admission and (3) donor age of 40 years or older. The ris k of graft failure for each of these factors was increased 2.2-, 3.2-, and 4-fold, respectively. Prolonged brain death was the only risk fac tor in the overall group, suggesting an association with early thrombo sis. Conclusions. Center-specific donor risk factors for pancreas graf t survival after simultaneous pancreas-kidney transplantation were ide ntified in this study, the importance of which need to be better defin ed: