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OPTN/SRTR 2013 Annual Data Report: pancreas.
R Kandaswamy1, M A Skeans, S K Gustafson
1Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Department of Surgery, University of Minnesota, Minneapolis, MN.
Summary
Pancreas transplants declined, but outcomes improved. New allocation systems aim for equitable access and reduced wait times, especially for simultaneous pancreas-kidney candidates. Graft failure definitions are being refined for better outcome analysis.
Area of Science:
- Nephrology
- Transplantation Immunology
- Organ Transplantation
Background:
- Pancreas listings and transplants have decreased over the last decade, with a notable decline in pancreas-after-kidney transplants.
- Despite decreasing numbers, pancreas transplant outcomes, both short-term and long-term, have shown improvement across all patient groups.
- Current challenges include interpreting outcomes due to a lack of uniform graft failure definitions and high risks of technical failures, rejection, and surgical complications.
Purpose of the Study:
- To summarize trends in pancreas transplantation, including changes in organ availability and patient outcomes.
- To outline upcoming changes to the national pancreas allocation system designed to improve efficiency and equity.
- To highlight ongoing challenges and the critical need for continued innovation in pancreas transplantation.
Main Methods:
- Analysis of national pancreas transplant data over the past decade.
- Review of changes implemented in the pancreas allocation system (effective late 2014).
- Discussion of efforts to establish a uniform definition for pancreas graft failure.
Main Results:
- A decrease in overall pancreas transplants, particularly pancreas-after-kidney transplants, was observed.
- Significant improvements in short-term and long-term pancreas transplant outcomes have been documented.
- New allocation policies will create a single national list, prioritizing simultaneous pancreas-kidney candidates to reduce wait times and mortality.
Conclusions:
- The new pancreas allocation system is expected to standardize organ distribution nationwide and decrease waitlist mortality for high-risk candidates.
- Establishing a uniform definition for graft failure is crucial for accurate future outcomes analysis and research.
- Continued advancements in pancreas transplantation are essential, especially with emerging alternatives like islet transplantation and artificial pancreas technology.
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