Risk factors and outcome in clinical pancreas transplantation

Author(s):
Kopp, W.H.
Published
2019
Publication type
Doctoral Thesis

Abstract

Pancreas transplantation is

the only long-lasting curative option patients with type 1 diabetes mellitus.

During the last 50 years, it has evolved from an experimental procedure to an

accepted treatment. For patients suffering from diabetes mellitus induced end-stage renal disease, a simultaneous pancreas-kidney transplantation is the best option. Due to increased experience, the indications for transplantation have been expanded, causing waiting lists to increase. To match the increasing demand, transplant professionals are forced to accept higher risk donor organs. This thesis investigates those risks and aims to quantify the risk in donor risk indices. Those risk indices were also investigated in this thesis. Furthermore, solitary risk factors for outcome were investigated. There appears to be a significant association between center volume and outcome: high volume center have better results than low volume centers, despite accepting higher risk donor organs. Another risk factor that was investigated was donation after circulatory death (DCD) pancreas transplantation. It showed that DCD pancreas transplantation is a feasible option to expand the donor pool.

Pancreas transplantationSimultaneous kidney pancreas transplantationOrgan transplantationOrgan donationDonor risk indexDonation after brain deathDonation after circulatory death
Defense date
2019-09-19
Language
English
Supervisor(s)
Hamming, J.F.
Advisor(s)
Braat, A.E.
Committee member(s)
Alwayn, I.P.J.; Reinders, M.E.J.; Putter, H.; Ploeg, R.J.; Pol, R.A.
Qualification
Ph.D.
Degree granting institution
Leiden University of Medical Center [LUMC], Leiden University, Leiden
hdl
1887/78451
ISBN(s)
9789463612876

Funding

Sponsorship
Nederlandse Transplantatievereniging Chipsoft Haaglanden Medisch Centrum LUMC, afdeling transplantatiechirurgie