LAUSR

A quarter of UK SPK transplants are from Deceased Cardiac Donors(DCD), with an increasing number recovered following in-situ normothermic regional perfusion(NRP). The aim of this study was to review the UK experience of SPK transplantation following NRP in DCD. Data were collected on all first DCD SPKTs(n=360) performed during 2013–2021 from the UK Transplant Registry. Non-NRP DCD SPK were compared to NRP DCD SPKs. Kaplan Meier plots and cox regression analyses were performed. Some 198 pancreas were offered from NRP donors with 83 being retrieved. The majority of SPK grafts were from nonNRP donors n=324(90.0%) with n=36(10.0%) from NRP donors. The median cold ischaemic time (CIT) from NRP donors (9.7 hours) was significantly less than nonNRP donors (10.2 hours) (p=0.013). For all other parameters, donors were well matched. Recipients who received a graft from an NRP donor were also well matched with the recipients who received a graft from a nonNRP donor. Univariate analysis showed no statistically significant difference in one-year pancreas graft (NRP 97.2%, non-NRP 89.2%, p=0.145), kidney graft (NRP 100%, nonNRP 95.9%, p=0.221) or patient survival (NRP 100%, nonNRP 98.3%, p=0.442) despite an increasing trend in favour of NRP SPK. This is the largest reported analysis of NRP for SPK transplants to date. NRP has previously been shown to be beneficial for liver transplants. Despite some concerns that NRP may preferentially benefit the liver at the expense of other organs our study has shown no adverse effects. Larger studies are needed to evaluate whether NRP improves graft utilisation rates for SPK.