title: OPTN/SRTR 2013 Annual Data Report: pancreas.
abstract: Pancreas listings and transplants decreased during the past decade, most notably pancreas after kidney transplants. Center-reported outcomes of pancreas transplant across all groups, short-term and long-term, improved during the same period. Changes to the pancreas allocation system creating an efficient, uniform national system will be implemented in late 2014. Pancreas-alone and simultaneous pancreas-kidney (SPK) candidates will form a single match-run list with priority to most SPK candidates ahead of kidney-alone candidates to decrease waiting times for SPK candidates, given their higher waitlist mortality compared with nondiabetic kidney transplant candidates. The changes are expected to eliminate local variability, providing more consistent pancreas allocation nationwide. Outcomes after pancreas transplant are challenging to interpret due to lack of a uniform definition of graft failure. Consequently, SRTR has not published data on pancreas graft failure for the past 2 years. The Organ Procurement and Transplantation Network Pancreas Transplantation Committee is working on a definition that could provide greater validity for future outcomes analyses. Challenges in pancreas transplantation include high risk of technical failures, rejection (early and late), and surgical complications. Continued outcome improvement and innovation has never been more critical, as alternatives such as islet transplant and artificial pancreas move closer to clinical application.
authors.affiliation: Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: R
authors.initials: R
authors.lastname: Kandaswamy
authors.forename: M A
authors.initials: MA
authors.lastname: Skeans
authors.forename: S K
authors.initials: SK
authors.lastname: Gustafson
authors.forename: R J
authors.initials: RJ
authors.lastname: Carrico
authors.forename: K H
authors.initials: KH
authors.lastname: Tyler
authors.forename: A K
authors.initials: AK
authors.lastname: Israni
authors.forename: J J
authors.initials: JJ
authors.lastname: Snyder
authors.forename: B L
authors.initials: BL
authors.lastname: Kasiske
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000847:Annual Reports as Topic; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D010182:Pancreatic Diseases / Q000601:surgery*; D010359:Patient Readmission; D040841:Resource Allocation; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists; D055815:Young Adult
keywords: Pancreas after kidney transplant; pancreas allocation policy; pancreas transplant alone; simultaneous pancreas-kidney transplant