OPTN/SRTR 2015 Annual Data Report: Pancreas

Abstract

The number of pancreas transplants performed in the United States stabilized over the last 3 years after nearly a decade of steady decline. Numbers of new additions to the list also stabilized during the same period. Notably, the persistent decline in pancreas after kidney transplants also seems to have abated, at least for now. The first full year of data after implementation of the new pancreas allocation system revealed no change in the distribution of organs between simultaneous pancreas-kidney (SPK) transplant and pancreas transplant alone. The percentage of kidneys used in SPK transplants was also unchanged. While a uniform definition of pancreas graft failure was approved in June 2015, it is awaiting implementation. Meanwhile, SRTR will refrain from publishing pancreas graft failure data in the program-specific reports. Therefore, it is difficult to track trends in outcomes after pancreas transplant over the past 2 years. New initiatives by the OPTN/UNOS Pancreas Transplantation Committee include facilitated pancreas allocation and broadened allocation of pancreata across compatible ABO blood types to increase organ utilization.

Impact of intensive dosing of mycophenolate on pancreas allograft survival

“…Simultaneous pancreas and kidney transplantation (SPK) remains an important treatment option for patients who have diabetes and suffer from end‐stage renal disease due to diabetic nephropathy. Recently reported data show that pancreas graft failure rates are declining, yet remain higher than rates of renal graft failure following SPK or non‐SPK deceased donor kidney transplant . This is thought to be entirely attributable to allograft rejection, as when compared to kidney transplant alone, SPK is associated with higher rates of rejection .…”

Pancreas transplantation in the treatment of diabetes mellitus type 1: modern aspects

“…На данный момент в США количество трансплантаций почки пациен-там с сахарным диабетом превысило количество трансплантаций пациентам с другими первичными причинами ХПН [4]. Частота нефропатии среди па-циентов, страдающих сахарным диабетом первого типа, в Российской Федерации составляет 21%, а с учетом показателей микроальбуминурии и протеин-урии -23 и 31% соответственно [1].…”

“…По данным Научного регистра трансплантиро-ванных реципиентов (SRTR), общее количество трансплантаций поджелудочной железы снизилось с 1500 в 2004 году до 900 в 2015 году, причем ос-новное снижение количества операций отмечено в группе пациентов, перенесших трансплантацию поджелудочной железы после ранее выполненной трансплантации почки [4,26]. Вероятным объяс-нением этой тенденции является тот факт, что пре-имущества при получении трансплантата подже-лудочной железы в сравнении с трансплантацией бета-клеток или с постоянной подкожной инфузией инсулина с помощью индивидуального носимого дозатора (помповой инсулинотерапией), на взгляд пациента, не столь значительны.…”

Deceased organ donor factors influencing pancreatic graft transplantation and survival

“…1 Solid organ pancreata can be transplanted individually, after a kidney transplant (pancreas-after-kidney [PAK]), or with a simultaneous pancreas-kidney (SPK) transplant. In the United States in 2015, there were approximately 1000 patients awaiting pancreas transplant, with the percentage of active listings at 65%, the highest in decades.…”