No difference in transplant outcomes for local and import pancreas allografts.
BACKGROUND
In the United States, pancreas allograft allocation is strictly regulated. Local centers have the first option to accept an organ, followed by regional and national allocation for those not accepted locally. For a pancreas to be imported, many centers must have previously rejected the organ for transplantation. This study reviews the outcomes of all pancreas allografts transplanted at a single center between January 2003 and November 2007. Early graft function and graft survival were stratified by geographic source of the donor pancreas.


METHODS
The records of 247 pancreas recipients and the donors of 11 imported and discarded pancreas allografts were reviewed. Pancreas allograft survival is represented using a Kaplan-Meier survival curve comparing (1) locally procured and imported pancreas grafts and (2) grafts procured by a team from our own center with the grafts procured by another team.


RESULTS
Of the 247 grafts, 184 (74%) were local and 63 (26%) were imported. There were no differences between the two geographic groups in 1-year graft survival (local 91%, import 90%, P=0.76). Similarly, graft survival was similar regardless of whether the organ was procured by our own team or by another center (local team 91%, another team 90%, P=0.96).


CONCLUSIONS
Pancreas allografts refused by a large number of centers may still be imported and successfully transplanted without affecting survival results.
Fridell
Jonathan A
JA
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. jfridell@iupui.edu
Mangus
Richard S
RS
Hollinger
Edward F
EF
Milgrom
Martin L
ML
Taber
Tim E
TE
Mohler
Elaine
E
Good
Jason
J
Goble
Michelle L
ML
Powelson
John A
JA
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D015203:Reproducibility of Results; D009927:Tissue and Organ Procurement / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome; D014481:United States