The Pancreas Can Take the Cold: Lower Waitlist Times Through Importation

Area of Science:

• Transplantation Medicine
• Organ Procurement
• Health Economics

Background:

• Regional waitlist times for pancreas transplantation can be lengthy.
• Pancreas importation is a strategy to address extended waitlist durations.
• This study evaluates the clinical and financial impact of pancreas importation.

Purpose of the Study:

• To assess clinical outcomes of pancreas importation versus local pancreas acquisition.
• To analyze the financial considerations of pancreas importation.
• To compare waitlist times and patient outcomes between imported and local pancreata.

Main Methods:

• Retrospective observational cohort study of 28 pancreas transplant recipients (2014-2017).
• Analysis of clinical parameters including hemoglobin A1c and complications.
• Comparison with United Network for Organ Sharing (UNOS) Region 9 data.
• Cost analysis including length of stay (LOS), standard acquisition (SAC) fees, and transportation.

Main Results:

• Pancreas importation significantly reduced waitlist times (518 days vs. 1001 days).
• Postoperative complications and 1-year HbA1c levels were similar between imported and local pancreas groups.
• Imported pancreata recipients had a longer average length of stay (11 days vs. 9.2 days).
• Pancreas importation was associated with higher mean charges ($445,968 vs. $325,470).

Conclusions:

• Pancreas importation effectively reduces waitlist times for pancreas transplantation.
• Clinical outcomes, including glucose control and graft survival, are comparable to local pancreata.
• Increased costs are primarily driven by longer length of stay.
• Importation may offer potential cost offsets and reduce societal burden despite higher direct costs.