Impact of Donor Substance Use on Outcomes Following Pancreas Transplantation.
- 1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
- 2Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana School of Medicine, Indianapolis, Indiana, USA.
Abstract
Background
Donor substance use is considered by many a risk factor for poor outcomes following pancreas transplantation, yet little is known regarding the impact of donor substance use on actual outcomes. This study aimed to determine the impact of substance use, particularly cocaine, on early and late outcomes following pancreas transplantation.Methods
This was a single center, retrospective analysis of all pancreas transplants from 2003-2023. Clinical outcomes including 30-day peak serum lipase, 7-day, 90-day, and 1-year pancreas allograft survival were assessed by donor exposure to substance use. As cocaine was of particular interest, a Kaplan-Meier analysis for positive vs negative cocaine tox screen was performed.Results
737 pancreas transplants were included. Donor substance use history included >20 pack years tobacco (40%) and marijuana (31%), with 11% of donors having history of cocaine use. Donor toxicology screens were positive for THC (26%), EtOH (22%), and benzodiazepines (22%). History of heavy alcohol use was associated with early allograft loss (7-day allograft loss 8% compared to 3%, p < 0.01) and EtOH positive toxicology screen was associated with higher 90-day allograft loss (8% vs 5%, p 0.02) and worse 1-year allograft survival (89% vs 93%, p < 0.01). There was no difference in clinical outcomes with donor exposure to cocaine.Conclusions
Only a donor history of ETOH use was associated with worse outcomes following pancreas transplantation. Donor exposure to cocaine was not associated with inferior outcomes. Donor substance use history or positive toxicology in the setting of an otherwise acceptable pancreas allograft, should not preclude transplantation.
Related
- Outcomes following Pancreatoduodenectomy in Patients ≥80 Years: An Analysis of the Prospective Pancreas Registry of the German Society for General and Visceral Surgery (DGAV|Registry Pancreas).
- United Network for Organ Sharing Policy Change Impact on Competing Risks in Heart Transplantation: Landmark Analysis of Waitlist Outcomes over Time
- Impact of prolonged balloon inflation on valve expansion and early clinical outcomes following contemporary balloon-expandable transcatheter aortic valve implantation
- Impact of Preoperative Chronic Opioid Use on Postoperative Outcomes Following Lumbar Fusion: A Nationwide Analysis
- A national propensity score-matched analysis of simultaneous pancreas and kidney transplantation from donation after circulatory death and brain death donors
BibTeX
@article{huber2026impact,
title = {{Impact of Donor Substance Use on Outcomes Following Pancreas Transplantation.}},
author = {Sarah Huber and Richard S Mangus and Quinton J Mangus and Andrew J Lutz and John A Powelson and Jonathan A Fridell},
journal = {Clinical transplantation},
year = {2026},
month = oct,
doi = {10.1111/ctr.70722},
url = {https://europepmc.org/article/MED/42911614},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Donor Substance Use on Outcomes Following Pancreas Transplantation.
AU - Sarah Huber
AU - Richard S Mangus
AU - Quinton J Mangus
AU - Andrew J Lutz
AU - John A Powelson
AU - Jonathan A Fridell
PY - 2026
DA - 2026/10/01
JO - Clinical transplantation
DO - 10.1111/ctr.70722
UR - https://europepmc.org/article/MED/42911614
AB - Background Donor substance use is considered by many a risk factor for poor outcomes following pancreas transplantation, yet little is known regarding the impact of donor substance use on actual outcomes. This study aimed to determine the impact of substance use, particularly cocaine, on early and late outcomes following pancreas transplantation.Methods This was a single center, retrospective analysis of all pancreas transplants from 2003-2023. Clinical outcomes including 30-day peak serum lipase, 7-day, 90-day, and 1-year pancreas allograft survival were assessed by donor exposure to substance use. As cocaine was of particular interest, a Kaplan-Meier analysis for positive vs negative cocaine tox screen was performed.Results 737 pancreas transplants were included. Donor substance use history included >20 pack years tobacco (40%) and marijuana (31%), with 11% of donors having history of cocaine use. Donor toxicology screens were positive for THC (26%), EtOH (22%), and benzodiazepines (22%). History of heavy alcohol use was associated with early allograft loss (7-day allograft loss 8% compared to 3%, p < 0.01) and EtOH positive toxicology screen was associated with higher 90-day allograft loss (8% vs 5%, p 0.02) and worse 1-year allograft survival (89% vs 93%, p < 0.01). There was no difference in clinical outcomes with donor exposure to cocaine.Conclusions Only a donor history of ETOH use was associated with worse outcomes following pancreas transplantation. Donor exposure to cocaine was not associated with inferior outcomes. Donor substance use history or positive toxicology in the setting of an otherwise acceptable pancreas allograft, should not preclude transplantation.
SN - 0902-0063
SN - 1399-0012
ER -