Surgery · Endocrinology · 2 h ago
Donor Alcohol History Linked to Worse Pancreas Transplant Outcomes
A single-center retrospective study of 737 pancreas transplants examined donor substance use and early and later graft outcomes. Donor alcohol history or a positive alcohol toxicology screen was associated with some measures of poorer graft survival; cocaine exposure was not.
- Heavy donor alcohol use was associated with higher 7-day graft loss.
- Positive alcohol screens were associated with poorer later graft outcomes.
- Cocaine exposure was not associated with differences in measured outcomes.
- The analysis was retrospective and from one transplant center.
Researchers retrospectively analyzed 737 pancreas transplants performed at one center from 2003 to 2023. They assessed 30-day peak serum lipase and pancreas allograft survival at 7 days, 90 days, and 1 year according to donor substance-use history and toxicology results. Donor histories included heavy alcohol use, tobacco use exceeding 20 pack-years, and cocaine use; toxicology screens were also assessed for several substances.
A history of heavy alcohol use was associated with higher 7-day graft loss (8% vs 3%; p<0.01). A positive donor alcohol toxicology screen was associated with higher 90-day graft loss (8% vs 5%; p=0.02) and lower 1-year graft survival (89% vs 93%; p<0.01). The study found no difference in clinical outcomes associated with donor cocaine exposure.
The findings suggest that donor cocaine exposure alone was not associated with inferior outcomes in this cohort. The authors state that substance-use history or a positive toxicology screen should not automatically preclude use of an otherwise acceptable pancreas allograft. Interpretation is limited by the retrospective, single-center design; the abstract does not provide adjusted estimates or details on potential confounding.
In practice
For teams assessing pancreas allografts, this single-center retrospective analysis of 737 transplants found that donor heavy alcohol-use history was associated with higher 7-day graft loss, while a positive alcohol toxicology screen was associated with higher 90-day loss and lower 1-year graft survival. Cocaine exposure was not associated with differences in measured outcomes. These findings do not establish causation or support a change in acceptance practice on their own; the analysis is retrospective and single-center, and the supplied abstract does not report adjusted estimates or details on confounding.
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Clinical Transplantation: Impact of Donor Substance Use on Outcomes Following Pancreas Transplantation ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.