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OPTN/SRTR 2011 Annual Data Report: pancreas.
R Kandaswamy1, P G Stock, M A Skeans
1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
Summary
Pancreas transplant numbers are down, but patient outcomes are improving for all types, including simultaneous pancreas-kidney, pancreas after kidney (PAK), and pancreas transplant alone (PTA). This trend reflects better donor and recipient selection and surgical techniques.
Area of Science:
- Transplantation immunology
- Organ transplantation outcomes
- Nephrology and Urology
Background:
- Pancreas transplant numbers have declined over the last decade.
- Simultaneous pancreas-kidney transplant, pancreas after kidney (PAK), and pancreas transplant alone (PTA) all show improving outcomes.
- Decreases in PAK transplants may correlate with reduced living donor kidney transplants.
Purpose of the Study:
- To analyze trends in pancreas transplantation numbers and outcomes.
- To identify factors contributing to improved post-transplant results.
- To highlight challenges in pancreas transplant data interpretation and patient care.
Main Methods:
- Analysis of national pancreas transplant waiting list data.
- Review of transplant rates, donor characteristics, and discard rates.
- Examination of post-transplant outcomes including re-hospitalization and rejection.
Main Results:
- Pancreas transplant rates decreased to 34.9 per 100 wait-list years in 2011.
- Organ donor rates declined, but donation after circulatory death increased.
- Higher discard rates were observed for pancreata from older donors.
- Improved outcomes are linked to better donor/recipient selection and surgical techniques.
- High rates of early post-transplant re-hospitalization and rejection, particularly in PTA recipients.
Conclusions:
- Despite declining numbers, pancreas transplant outcomes are improving due to advancements in selection and technique.
- Standardizing graft failure definitions is crucial for accurate outcome interpretation.
- PTA recipients face higher risks of rejection and post-transplant lymphoproliferative disorder.
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