Pancreas Transplantation in the Modern Era: Observations and Implications of Donor Pancreas Extraction Time

There has been a worldwide reduction in pancreas transplant volume over the last decade. Understanding factors, such as procurement extraction time (ET), that play a key role in organ recovery can increase confidence in organ acceptance and improve organ utilization. All patients who underwent deceased donor pancreas transplantation at a single US center between January 2019 and August 2024 were stratified by ET and retrospectively reviewed. A total of 137 transplants were included in the analysis with 72 patients in the ET ≤ 40 min group and 65 patients in the ET > 40 min group. We found no significant difference in all-cause pancreas graft loss between the ET ≤ 40 min and ET > 40 min group (6.9% vs 12%; p = 0.482), but there was a higher readmission rate at 90 days in the ET ≤ 40 min group (60% vs 39%; p = 0.015) regardless of adjustments in multivariate analysis. We demonstrate for the first time at a US center that while ET is not associated with all-cause graft loss, it may impact postoperative outcomes such as readmission rates and could have important implications for the future of pancreas utilization.