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Updated: Jul 15, 2026
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Normothermic Ex Vivo Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation
Published on: July 27, 2022
The rationale for the new deceased donor pancreas allocation schema
Mark D Stegall1, Patrick G Dean, Randall Sung
1Department of Surgery, Division of Transplantation Surgery, Mayo Clinic, Rochester, MN 55905, USA. stegall.mark@mayo.edu
Transplantation
|May 15, 2007
Summary
Pancreas allocation policies have been updated to prioritize islet transplantation for older or obese donors. This aims to improve organ utilization and transplant success rates, addressing issues of non-recovery and graft survival.
Area of Science:
- Transplantation immunology
- Organ allocation policy
- Graft survival analysis
Background:
- Deceased donor pancreas allocation policy requires continuous evolution for successful whole organ and islet transplantation.
- Assessing current policies is crucial for optimizing organ utilization and patient outcomes.
Purpose of the Study:
- To analyze the disposition and outcomes of deceased donor pancreata in the U.S. from 2000-2003.
- To inform the development of improved pancreas and islet transplantation allocation strategies.
Main Methods:
- Retrospective analysis of deceased donor pancreas data from the Organ Procurement and Transplantation Network (OPTN).
- Evaluation of donor characteristics (age, BMI) and their impact on pancreas recovery and transplant outcomes.
Main Results:
- 48% of donors had pancreata not recovered, primarily due to perceived poor quality or placement issues.
- Whole organ pancreas transplants predominantly used donors aged ≤50 years and BMI ≤30 kg/m².
- Lower graft survival observed for simultaneous pancreas-kidney transplants from donors >50 years and trends for BMI >30 and longer cold-ischemia times.
Conclusions:
- The OPTN implemented a new allocation algorithm prioritizing islet transplantation for pancreata from donors >50 years or BMI >30 kg/m², unless accepted locally.
- Significant numbers of viable pancreata are not procured, highlighting the need for better communication between organ procurement organizations and transplant programs.
