Pancreas transplantation using compatible but non-identical ABO blood group donors

Clin Transplant. 2018 Jul;32(7):e13284. doi: 10.1111/ctr.13284. Epub 2018 Jun 20.

Abstract

Background: There are limited data on the outcomes of pancreas transplants using ABO non-identical but compatible (NIC) donors.

Methods: A review of all pancreas transplants from a single institution from 01/2003 to 07/2016 (n = 606) revealed 41 recipients of a NIC donor pancreas which were matched for age, race, gender, year, and type of transplant with 41 ABO identical cases. Groups were compared for allograft survival, incidence of acute cellular rejection (ACR), length of hospital stay, 3-month readmissions and transfusion requirements. Serum haptoglobin and lactate dehydrogenase were used to identify hemolysis in patients requiring repeated transfusions without overt blood loss.

Results: The 1-year graft survival was 100% and 88% in the study and control groups. In the study group, 6/41(14%) developed hemolysis, all of which were ABO O into A. All responded to donor blood type specific transfusions.

Discussion: There are limited data on outcomes of solid organ transplant using NIC donors with almost none specifically addressing pancreas transplantation. In this study, graft survival was similar but 14% developed hemolysis, which was transient and treated with transfusion of donor blood type specific blood.

Conclusion: Non-identical but compatible pancreas transplants have similar graft survival compared to ABO identical. Hemolysis may occur so some caution is required.

Keywords: ABO blood group; non-identical blood group transplantation; pancreas transplantation.

MeSH terms

  • ABO Blood-Group System / immunology*
  • Adult
  • Female
  • Follow-Up Studies
  • Graft Survival*
  • Histocompatibility / immunology*
  • Humans
  • Living Donors*
  • Male
  • Middle Aged
  • Pancreas Transplantation*
  • Prognosis
  • Retrospective Studies
  • Risk Factors

Substances

  • ABO Blood-Group System