EFFECT OF BLOOD-GROUP AND HLA MATCHING ON PANCREAS GRAFT-SURVIVAL WITH THE USE OF UW SOLUTION

Pancreas graft survival is influenced by various donor and recipient f actors. Factors that have posed serious problems to pancreas transplan tation have included the limited cold ischemia time, early graft throm bosis, and rejection. A limited cold ischemia time not only causes pro blems in terms of logistics but also implies limitations with regard t o HLA matching and organ exchange. Between August 1988 and August 1989 we performed a prospective, nonrandomized European multicenter study to evaluate the effect of University of Wisconsin (UW) solution on pan creas graft survival. In addition, donor and recipient factors were co llected and their influence on graft survival analyzed. Overall pancre as graft survival at 1 and 4 years was 67 % and 59 %, respectively (n = 62). When only simultaneous pancreas and kidney transplants were inc luded, the graft survival was 70 % and 63 % at 1 and 4 years, respecti vely. The incidence of pancreas graft thrombosis was 8 %. Cold ischemi a time was not found to significantly influence pancreas graft surviva l even when it exceeded 12 h. Factors that did were HLA-DR matching, s imultaneous pancreas and kidney transplantation versus pancreas transp lantation alone, and ABO blood group matching. We feel that the use of UW solution for pancreas preservation has contributed to improved pan creas graft survival and has reduced early graft thrombosis despite mu ch longer cold ischemia times of over 12 h. Given this and the signifi cant effect of HLA and blood group matching, we conclude that more att ention should be paid to preoperative matching and organ exchange in o rder to further improve pancreas graft survival.