Are the Outcomes of Japanese Pancreas Transplantation Utilizing Extended Criteria Donors Acceptable? - A propensity score matching analysis for donors <50 or ≥50 years old.

BACKGROUND: In Japan, about 30% of pancreatic transplant donors are ≥50 years old, making them "extended criteria donors". METHODS: We analyzed 361 cases of transplantation involving donors from the Japanese pancreas transplantation registry to evaluate the acceptability of extended criteria donors. RESULTS: The patient survival rates at 1, 5, and 10 years after transplantation were 96.6%, 94.9%, and 88.3%, respectively. The survival rates of pancreas and kidney grafts at 1, 5, and 10 years were 85.3%, 74.8%, 70.6% and 94.2%, 90.9%, and 80.9%, respectively. Multivariate analysis revealed that no particular donor factors significantly influenced the pancreatic graft survival. Patients were divided into 2 groups: donors ≥50 years old (older group) and those <50 years old (younger group). After propensity score matching, the overall pancreatic graft survival at 1, 5, and 10 years after transplantation in the older group was 82.8%, 71.8%, and 69.5%, respectively, which was almost the same as in the younger group (84.9%, 70.2%, and 67.4%, respectively). CONCLUSIONS: No donor factors markedly influenced the pancreatic graft survival, and the outcomes of pancreas transplantation from extended criteria donors ≥50 years old were comparable to those from younger donors.