Sydney School of Public Health
The University of Sydney
Donor characteristics of pancreas transplants in Australia and New Zealand: a cohort study 1984-2014
Xi (Alex) Peng1, Patrick J Kelly1, Angela C Webster1,2, on behalf of ANZIPTR and contributors2.
1Sydney School of Public Health, The University of Sydney, Sydney, Australia; 2Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
Introduction Pancreas transplantation was first conducted in Australian and New Zealand (ANZ) in 1984. The aim of this study is to describe the characteristics of pancreas donors in ANZ since 1984 and to examine changes over time.
Methods Data from the Australia and New Zealand Islet and Pancreas Transplant Registry (ANZIPTR) were used to investigate donor characteristics: sex, age, BMI, smoking status, blood group, positive cytomegalovirus (CMV) and Epstein-Barr virus (EBV) status, hypertension, number of arteries, multiple organ donation, and cause of death. Categorical and continuous characteristics were summarised as proportions and means respectively. Changes over time were assessed using Pearson Chi-square tests (or Fishers Exact tests if required) and ANOVA. Summaries and analyses over time were based on categorising year of transplant into the following periods: 1984-1994 and then five year periods; 1995-1999, 2000-2004, 2005-2009, and 2010-2014.
Results There were 627 pancreas transplants reported from 1984 to 2014 in ANZ, of which 583 were conducted in Australia and 44 in New Zealand. Donors’ average age has increased from 26.6 years from 1984-94 to 28.5 years in 2010-14 (p=0.02). Average BMI has increased from 22.8 kg/m2 to 24.0 kg/m2 (p=0.01), with the percentage being overweight or obese increasing from 18% to 39%. The proportion of donors with hypertension and who smoke has decreased substantially over time, from 16% to 1% (p<0.001) and from 54% to 15% (p<0.001), respectively. Positive EBV status has increased over time (70% to 90%; p<0.001), whereas CMV status has remained constant across the period (p =0.68), with 69% being positive. Donor blood groups have also remained constant, with 46% being type 0 and 41% being type A. Donors’ cause of donor death has changed over time (p=0.003), with an increase in deaths due to cerebral hypoxia/ischaemia (from 2% to 16%) and a reduction in intracranial haemorrhage deaths (from 39% to 14%). Traumatic brain injury remains the most common cause of death (50% to70% of deaths).
Conclusions Many donor characteristics have changed over time. Donors have become older and fatter but are now much less likely to have hypertension or to be a smoker. Positive EBV status has increased but CMV status appears stable. Donors’ cause of death has also changed.
11:00 - 12:30
|Progress and clinical outcomes in pancreas transplantation||Recipient and pancreas graft survival after simultaneous kidney-pancreas transplantation in Australia and New Zealand: a cohort study 1984-2014||Room 110|
15:30 - 17:00
|Pancreas & Islet Donors: Assessing Risk and Optimizing Outcomes||Donor characteristics of pancreas transplants in Australia and New Zealand: a cohort study 1984-2014||Room 110|