Elevated liver enzymes at the time of deceased donor organ donation do not affect recipient or pancreas allograft survival following pancreas transplantation

Evan M Sood; Fernando Bomfim; Abbigail Delmonte; Kendall DeSantis; Rosy James; Naoru Koizumi; Robert Plews; Jorge Ortiz

doi:10.1016/j.hpb.2024.04.012

Elevated liver enzymes at the time of deceased donor organ donation do not affect recipient or pancreas allograft survival following pancreas transplantation

HPB (Oxford). 2024 Apr 24:S1365-182X(24)01278-4. doi: 10.1016/j.hpb.2024.04.012. Online ahead of print.

Authors

Evan M Sood¹, Fernando Bomfim¹, Abbigail Delmonte¹, Kendall DeSantis¹, Rosy James², Naoru Koizumi², Robert Plews³, Jorge Ortiz⁴

Affiliations

¹ Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA.
² George Mason University, 4400 University Dr, Fairfax, VA, 22030, USA.
³ Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
⁴ Department of Surgery, Erie County Medical Center, 462 Grider St, Buffalo, NY, 14215, USA. Electronic address: jortiz22@buffalo.edu.

PMID: 38763805
DOI: 10.1016/j.hpb.2024.04.012

Abstract

Background: There is a lack of data on the impact of donor liver function tests (LFTs) on pancreas transplantation outcomes. Understanding their contribution could expand the donor pool.

Methods: Using the UNOS database, data from January 2010-2022 was retrospectively analyzed. Multivariable cox regressions were performed to evaluate the association between LFTs (AST, ALT and total bilirubin levels), graft failure and mortality up to three years post-transplant.

Results: 9138 pancreas transplants were completed. Multivariate analysis showed no association between donor AST values > 500 U/L and increased rates of graft failure (p = 0.826) or mortality (p = 0.836). Similar findings were noted for donor ALT values > 500 U/L (p = 0.522 and p = 0.997, respectively). There was no correlation with graft failure (p = 0.322) or mortality (p = 0.423) for total bilirubin levels >3 mg/dL.

Conclusion: LFTs in the deceased pancreas donor did not increase risk of graft failure or mortality following pancreas transplantation. Elevated LFTs should not serve as absolute contraindications to transplant.