Importing pancreata for transplantation: a single-center experience across evolving allocation eras

Area of Science:

• Transplantation immunology
• Organ procurement and allocation
• Nephrology and urology

Background:

• Recent allocation system changes have expanded geographic distribution of pancreas offers.
• Wider organ sharing may impact transplant outcomes, but this remains uncertain.

Purpose of the Study:

• To analyze the impact of donor hospital distance on pancreas transplant outcomes.
• To evaluate graft survival, patient survival, and thrombosis rates for imported vs. local pancreata.

Main Methods:

• Retrospective analysis of primary pancreas transplants (2000-2018) at a single center.
• Stratification based on donor hospital distance (nautical miles).
• Comparison of simultaneous pancreas-kidney (SPK), pancreas after kidney (PAK), and pancreas transplant alone (PTA) outcomes.

Main Results:

• No significant differences in death-censored graft survival or patient survival were observed based on donor hospital distance.
• Graft thrombosis rates were comparable across all distance groups.
• Imported pancreata came from younger donors with lower BMI compared to local grafts.

Conclusions:

• Importing pancreata for transplantation is a safe and feasible practice.
• Wider organ sharing increases organ utilization, reduces wait times, and improves patient access to pancreas transplantation.
• Encouraging wider importation can optimize transplant center resources and patient outcomes.