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Jannik Hinzmann, Sascha Grzella, Thorsten Lengenfeld, Nina Pillokeit, Marielle Hummels, Hans-Martin Vaihinger, Timm Westhoff, Richard Viebahn, Peter Schenker

• Previous cardiac arrest in brain‐dead donors has been discussed as a potential risk factor in pancreas transplantation (PT), leading to a higher rate of organ refusal. This study aimed to assess the impact of cardiopulmonary resuscitation (CPR) in brain‐dead donors on pancreas transplant outcome. A total of 518 type 1 diabetics underwent primary simultaneous pancreas–kidney (SPK) transplantation at our center between 1994 and 2018. Patients were divided into groups, depending on whether their donor had been resuscitated or not. A total of 91 (17.6%) post‐CPR donors had been accepted for transplantation (mean duration of cardiac arrest, 19.4 \(\pm\) 15.6 min). Those donors were younger (\(\it P\) < 0.001), had lower pancreas donor risk index (PDRI, \(\it P\) = 0.003), and had higher serum creatinine levels (\(\it P\) = 0.021). With a median follow‐up of 167 months (IQR 82–229), both groups demonstrated comparable short‐ and long‐term patient and graft survival. The resuscitation time (<20 min vs. ≥20 min) also showed no impact, with similar survival rates for both groups. A multivariable Cox regression analysis suggested no statistically significant association between donor CPR and patient or graft survival. Our results indicate that post‐CPR brain‐dead donors are suitable for PT without increasing the risk of complications.