Elevated Liver Enzymes at the Time of Deceased Donor Organ Donation Do Not Affect Recipient or Pancreas Allograft Survival Following Pancreas Transplantation

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 9,138 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. Discussion 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.