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OPTN/SRTR 2012 Annual Data Report: pancreas.
A K Israni1, M A Skeans, S K Gustafson
1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN.
Summary
Pancreas transplants have declined, but a new allocation policy may improve access and reduce wait times. Long-term survival is better for simultaneous pancreas-kidney transplants compared to other types.
Area of Science:
- Nephrology
- Transplant Surgery
- Immunology
Background:
- Pancreas transplantation, including pancreas after kidney (PAK) and pancreas transplant alone (PTA), has seen a decade-long decline.
- Deceased donor pancreas donation rates have been low since 2005.
- Graft outcomes are challenging to assess due to inconsistent definitions of graft failure.
Purpose of the Study:
- To analyze trends in pancreas transplantation.
- To evaluate the potential impact of a new national pancreas allocation policy.
- To compare outcomes of different pancreas transplant types.
Main Methods:
- Analysis of pancreas transplant trends and donation rates.
- Review of a new national pancreas allocation policy combining waiting lists for PAK, PTA, and simultaneous pancreas-kidney (SPK) transplants.
- Comparison of long-term graft survival rates between SPK, PAK, and PTA procedures.
Main Results:
- Pancreas transplantation numbers, particularly PAK and PTA, have decreased.
- The new allocation policy aims to equalize priority and reduce geographic disparities in wait times.
- Long-term survival is superior for SPK transplants compared to PAK and PTA.
- Pancreas transplant recipients experience high rehospitalization rates within six months and increased rejection incidence versus kidney transplant.
Conclusions:
- A new national policy may revitalize pancreas transplantation by standardizing allocation and reducing wait times.
- Simultaneous pancreas-kidney transplants demonstrate better long-term outcomes, possibly due to easier rejection monitoring.
- Pancreas transplantation faces challenges including low donation rates, inconsistent outcome definitions, and high post-transplant complication rates.
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The pancreas, an essential organ in the human body, is a pinkish-gray elongated structure located posterior to the stomach. It extends laterally from the duodenum towards the spleen and is firmly bound to the posterior wall of the abdominal cavity. The organ's surface has a lumpy, lobular texture that gives it a unique appearance.
The broad head of the pancreas lies within the loop formed by the duodenum, while its slender body reaches towards the spleen. The tail of the pancreas is short...
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