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OPTN/SRTR 2019 Annual Data Report: Pancreas.
R Kandaswamy1,2, P G Stock1,3, J Miller1
1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.
Summary
Pancreas transplants saw a slight decrease in 2019, but simultaneous pancreas-kidney transplants increased. Patient and graft survival outcomes continue to improve, offering hope for transplant recipients.
Area of Science:
- Nephrology
- Transplant Surgery
- Endocrinology
Background:
- Pancreas transplantation is a vital treatment for end-stage renal disease and type 1 diabetes.
- Trends in pancreas transplantation, including simultaneous pancreas-kidney (SPK), pancreas-after-kidney (PAK), and pancreas-transplant-alone (PTA) procedures, are crucial for resource allocation and patient management.
- Monitoring waitlist dynamics and recipient demographics provides insights into the evolving landscape of pancreas transplantation.
Purpose of the Study:
- To analyze recent trends in pancreas transplantation volume, waitlist registrations, and waiting times.
- To evaluate short- and long-term outcomes of pancreas transplants, including patient survival and graft survival.
- To identify shifts in the types of pancreas transplant procedures performed and the characteristics of patients on the waitlist.
Main Methods:
- Retrospective analysis of national pancreas transplant data from 2018 to 2019.
- Examination of waitlist registration numbers and demographic data, focusing on SPK, PAK, and PTA categories.
- Assessment of patient survival, kidney graft survival, and acute rejection-free graft survival rates.
Main Results:
- Overall pancreas transplants slightly decreased from 1027 in 2018 to 1015 in 2019.
- Simultaneous pancreas-kidney transplants (SPKs) increased, while pancreas-after-kidney (PAK) and pancreas-transplant-alone (PTA) decreased.
- Waitlist registrations rose to 1772 in 2019, driven by SPK and type 2 diabetes patients; SPK waiting time decreased to 12 months, while PTA remained high at 24 months.
- Consistent improvements in patient survival, kidney graft survival, and acute rejection-free graft survival were observed over the past decade.
Conclusions:
- Despite a slight overall decrease, the rise in SPKs and improving long-term outcomes highlight advancements in pancreas transplantation.
- The increasing waitlist, particularly for SPK recipients with type 2 diabetes, necessitates continued monitoring and resource planning.
- Ongoing data collection by the Organ Procurement and Transplant Network (OPTN) will further refine understanding of pancreas graft survival under uniform definitions.
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