Purpose We wanted to compare glycemic control post pancreas transplantation with newer therapeutic options. Methods We conducted a retrospective analysis of pancreas transplantation at our institution from January 1, 2008, through September 30, 2021. All patients who underwent pancreatic transplantation were 18 years and older. We compared pre‐transplant glycemic control of those patients, whether self‐monitoring or continuous glucose monitor to their post‐transplant glycemic control. Outcomes were assessed by HgbA1C level at evaluation (eval), pretransplant (pre), within the first 5 months posttransplant (post) and 1 year post transplant (1 year). Results One hundred and thirty‐four patients underwent pancreas transplantation during the 14‐year study period. Overall, 1‐year patient and graft survival were 95% and 88%. The mean HgbA1C (%) for eval and pre were 8.5(SD ± 1.7) and 8.3(SD ± 1.7), which was significantly higher than post, and 1 year at 5.1(SD ± .6, p < .01) and 5.2(SD ± .6, p < .01). Of those, 38 patients presented with continuous glucose monitors (CGM) +/− pump. Their mean HgbA1C(%) was 8.2(SD ± 1.5) at eval 8.1(SD ± 1.3). These were also significantly higher than post 5.0(SD ± .6, p < .01), and 1 year 5.1(SD ± .5, p < .01). Conclusion Pancreas transplant provides superior glycemic control to continuous glucose monitoring and remains the optimal therapy for appropriately selected patients with diabetes.

BackgroundTo address long waitlist times and increase pancreas transplantation, our center has implemented a protocol for long‐distance importation of pancreata.MethodsWe conducted a retrospective review of pancreas transplantation at our institution from January 1, 2014, the start of our importation program, through September 30, 2021. Outcomes were compared between locally procured grafts and imported grafts, defined as grafts procured greater than 250 nautical miles (NM) from our center.ResultsEighty‐one patients underwent pancreas transplantation during the study time period; 19 (23.5%) received imported grafts. There were no significant differences in recipient demographics or type of transplant received. Mean distance of import was 644.2 ± 234.0 NM. Imported grafts were more likely to be from pediatric donors <18 years old (p = .02) and a significantly higher proportion of imported grafts came from donors weighing <30 kg (26.3 vs. 3.2%, p = .007). Cold ischemic time was longer for imported grafts than for local grafts (13.4 ± 2.3 h vs. 9.8 ± 2.2 h, p < .01). There was no significant difference in deaths or graft losses within 90 days or at 1 year between groups.ConclusionCenters should consider expanding criteria for acceptance of imported pancreata to increase the number of transplants and combat organ nonutilization.

Kidney transplantation provides numerous important benefits compared with dialysis for children with end-stage kidney disease. In addition to improved survival, transplantation is associated with better quality of life, linear growth, pubertal development and neuropsychiatric development compared with maintenance dialysis. [1][2][3][4][5][6] Given these time-sensitive benefits during a key developmental period, kidney allocation in the United States has historically prioritized expedited transplantation for wait-listed pediatric candidates.