OPTN/SRTR 2023 Annual Data Report: Pancreas

Area of Science:

• Nephrology
• Endocrinology
• Transplant Surgery

Background:

• Pancreas transplantation is a vital treatment for select patients with diabetes.
• Trends in pancreas transplant volume, recipient demographics, and donor utilization are crucial for resource allocation and patient outcomes.
• Understanding changes in waiting list composition and transplant center practices informs future strategies.

Purpose of the Study:

• To analyze the trends in pancreas transplantation in the United States during 2023.
• To examine changes in recipient and waiting list demographics, particularly focusing on type 2 diabetes, age, and obesity.
• To assess donor utilization, transplant center volume distribution, and transplant outcomes.

Main Methods:

• Retrospective analysis of national pancreas transplant data for 2022 and 2023.
• Examination of recipient and waiting list characteristics, including diabetes type, age, and body mass index.
• Review of donor data, transplant center activity, and graft survival rates.

Main Results:

• Overall pancreas transplants remained stable (915 in 2023 vs. 918 in 2022).
• Pancreas-after-kidney transplants declined to a decade low (36 in 2023).
• Proportion of recipients and candidates with type 2 diabetes increased, alongside a rise in older and obese candidates on the waiting list. Donor numbers decreased, but nonuse rates also fell. Transplant outcomes remained stable, with high 1-year graft survival rates for simultaneous pancreas-kidney transplants (90.8% pancreas, 96.2% kidney).

Conclusions:

• While overall pancreas transplant numbers are stable, a concerning shift towards a higher prevalence of type 2 diabetes, older, and obese candidates is observed.
• The decline in pancreas-after-kidney transplants warrants further investigation.
• Stable transplant outcomes highlight the continued efficacy of pancreas transplantation, particularly in simultaneous pancreas-kidney procedures.