Introduction•Brain stem death causes high levels of systemic catecholamines and inflammation affecting all organs.•Hyperglycaemia following brain death is common and is managed with insulin in about half of all donors.Aim•We hypothesised that donor insulin use (DIU) is a marker of irreversible pancreatic beta-cell death.•We aimed to assess relationships of DIU to pancreas transplant outcome and function.MethodsResults•National data from the UK Transplant registry (2004-2016) was reviewed retrospectively to determine donor variables associated with DIU and its relationship with graft survival.•Early non-technical graft failure (transplant pancreatitis) was assessed from histology reports using our regional data.•In a sub-group, we determined relationships between DIU and early c-peptide secretion
