SRS192 - OPTN data registry national cohort study—donor lipase and amylase do not predict pancreas transplant outcomes

Abstract Introduction Simultaneous pancreas-kidney (SPK) transplantation improves the quality of life of patients with diabetes and end-stage renal disease, and reduces diabetes-related complications. However, elevated donor serum lipase and amylase often lead to organ refusal due to concerns over potentially inferior outcomes. We aim to evaluate whether donor serum lipase and amylase predict pancreas transplant outcomes. Methods A retrospective cohort study was conducted using Organ Procurement and Transplantation Network data on adult SPK transplants from 2010–2023. Adjusted regression models examined associations between donor peak serum lipase/amylase and 1-year pancreas graft survival. Results 10 451 SPK recipients were included, median peak donor lipase was 38U/L (IQR 18–92, max 2985) and median amylase was 84U/L (Fig 1b; IQR 45–168, max 2831). After adjustment for confounders, neither peak donor lipase/amylase significantly affected graft survival (aHR = 1.019; 95% c.i. 0.980–1.059 and aHR = 0.986; 95% c.i. 0.943–1.031, respectively). Interaction analyses found no evidence that peak lipase/amylase trends leading up to donation influenced outcomes (P = 0.250 and P = 0.492, respectively). Restricted cubic splines were used to assess the relationship between these enzymes and graft survival which confirmed that neither had a significant impact on pancreas transplant outcome. Conclusions Donor lipase and amylase levels do not predict pancreas graft outcomes. Therefore, raised donor serum lipase and amylase should not be considered a barrier to organ utilisation. Incorporating such donors is a simple approach to expand the pancreas donor pool while minimising organ discard at the same time.