Pancreas Donor Risk Index and Preprocurement Pancreas Suitability Score for Prediction of Pancreas Transplant Outcomes

Objectives: The Pancreas Donor Risk Index and Preprocurement Pancreas Suitability Score were designed to assist in the evaluation of pancreases for transplant. Preprocurement Pancreas Suitability Score <17 and Pancreas Donor Risk Index <= 1.57 were deemed ideal. We aimed to determine the ability of these scores to predict pancreas transplant outcomes. Materials and Methods: The Pancreas Donor Risk Index and the Preprocurement Pancreas Suitability Score were retrospectively calculated from a prospectively maintained database of consecutive pancreas transplants performed during a 13-year period (December 2004 to November 2017). Outcomes measured were rejection rate, graft and patient survival, and duration of hospital stay. Results: Of 159 pancreas transplants (108 simultaneous pancreas and kidney transplants, 33 pancreas after kidney transplants, 18 pancreas-only transplants), full data were available for 155 (97%) to calculate Pancreas Donor Risk Indexes and 129 (81%) to calculate Preprocurement Pancreas Suitability Scores. Fortyseven patients (30%) experienced at least 1 episode of acute rejection. We calculated Pancreas Donor Risk Indexes for 155 patients, and 19 (23%) and 27 (38%) were in the <= 1.57 and >1.57 groups, respectively (P = .047). We calculated Preprocurement Pancreas Suitability Scores for 129 patients, and 12 (21%) and 27 (32%) were in the <17 and 17 groups, respectively (P = .202). Donor age and recipient female sex were the main predictors for rejection (binary logistic regression, P < .05). One-year graft survival rates were 95% and 81% for the <= 1.57 and >1.57 Pancreas Donor Risk Index groups, respectively, and 95% and 80% for the <17 and >= 17 Preprocurement Pancreas Suitability Score groups, respectively (not significant). Conclusions: Pancreas Donor Risk Index and Preprocurement Pancreas Suitability Score were not helpful to predict graft/patient survival in our population. A higher Pancreas Donor Risk Index was associated with higher risk of graft rejection. Further studies with larger cohorts are required.