Journal of the Pancreas Open Access

Evaluating Donor Selection and Organ Viability in Pancreas Surgery

Helena Duarte^* Department of Clinical Sciences, Federal University of Parana, Curitiba, Brazil
^*Correspondence: Helena Duarte, Department of Clinical Sciences, Federal University of Parana, Curitiba, Brazil, Email:

Received: 31-Jul-2025, Manuscript No. IPP-25-23037; Editor assigned: 02-Aug-2025, Pre QC No. IPP-25-23037; Reviewed: 16-Aug-2025, QC No. IPP-25-23037; Revised: 22-Aug-2025, Manuscript No. IPP-25-23037; Published: 30-Aug-2025, DOI: 10.36648/1590-8577.26.3.926

Description

The suitability of a pancreas for surgical transfer depends on several interconnected factors that determine organ condition, safety and long-term function. Donor evaluation is therefore a decisive step that directly influences the outcome for the recipient. Clinicians carefully analyze a wide range of characteristics, beginning with the donor’s health background, lifestyle habits and lab findings, because each of these elements provides insight into whether the pancreas can withstand retrieval, preservation and eventual use in a patient with advanced metabolic disease. The process is detailed and calls for accurate judgment, since even minor oversights may affect the organ’s performance after surgery. One of the first aspects specialists assess is donor age. Although pancreases from younger donors are generally preferred due to their stronger structural integrity, age alone never determines acceptance. Many older donors possess organs in remarkably functional condition, while some younger donors may present issues that affect suitability. The focus remains on overall organ quality rather than strict age limits. Physicians review past diagnoses, medications, infections and any history of abdominal injury to understand potential effects on pancreatic tissue. Conditions such as prolonged low blood pressure, certain viral infections or severe trauma can lead to cellular stress that reduces functional capacity. As a result, every detail of the medical timeline receives close attention.

Donor body mass index is another important factor. Excess body fat can influence the condition of the pancreas, sometimes making the organ more challenging to remove and prepare. Higher fat content may also affect the blood vessels, which are essential for connecting the organ successfully during surgery. Nevertheless, experienced teams can still accept donors with increased and when the pancreas displays healthy appearance during visual inspection. Decisions rely on a balanced evaluation rather than rigid cut-offs and surgeons consider whether potential concerns can be managed effectively. Laboratory values help reveal unseen issues. For instance, high glucose levels before death might suggest impaired pancreatic function, though this is not always the case. Elevated enzyme levels could indicate inflammation, yet interpretation requires caution because certain enzymes commonly rise during critical illness even without permanent damage. Skilled clinicians combine lab data with imaging studies, medical records and direct examination to determine whether an abnormal value represents a temporary situation or a sign of deeper tissue injury.

The conditions surrounding the donor’s final hospitalization also influence viability. Extended stays in intensive care, prolonged use of certain medications or unstable circulation may introduce challenges. However, these factors do not automatically rule out donation. Instead, specialists monitor how well the pancreas maintains normal appearance during the period leading up to organ retrieval. The timing between cardiac arrest in some cases and organ cooling is especially important, as delays may reduce cellular integrity. Prompt retrieval and effective cooling techniques limit deterioration and improve the likelihood that the organ will function well after surgery. The retrieval procedure itself requires accuracy. A pancreas is delicate, with blood vessels and ducts that must be protected from damage. Surgeons remove the organ while preserving as much vascular structure as possible, enabling easier connection to the recipient. Any accidental injury during this stage could compromise success. Following removal, the organ is placed in a preservation solution designed to slow cellular activity and reduce energy demands. Temperature control is essential and teams continuously monitor cooling conditions during transport. Even a short lapse in proper storage may affect the organ’s ability to resume full function later.

Once the organ arrives at the recipient center, specialists re-evaluate it before proceeding. Visual inspection remains one of the most reliable methods for determining suitability. Surgeons examine color, firmness, fat distribution and vascular condition, looking for indications of stress or injury. Modern imaging and lab testing support this examination, although no single test can replace the judgment of trained professionals. Pancreases showing severe swelling, excessive fat infiltration or vessel damage may be declined at this stage. Conversely organs that appear healthy despite minor concerns earlier in the process may still be judged acceptable. The ultimate objective is to provide recipients with an organ capable of restoring stable metabolic function over the long term. Every decision from initial donor screening to final inspection aims to balance safety with the need to offer timely options for patients. Because the pool of suitable donors is limited, clinicians must carefully weigh risks while ensuring that recipients receive organs of adequate quality. Strategies to improve donor management, refine evaluation methods and enhance preservation continue to evolve, with the intention of increasing successful outcomes. Through careful donor selection and detailed assessment of viability, medical teams maximize the likelihood that the pancreas will function effectively after surgery. Although challenges remain, continuous improvements in evaluation and preservation allow clinicians to make more confident decisions, ultimately benefiting patients who rely on these procedures for restored metabolic health.