OPTN/SRTR 2016 Annual Data Report: Pancreas

Abstract

The number of pancreas transplants performed in the United States increased by 7.0% in 2016 over the previous year, the first such increase in more than a decade, largely attributable to an increase in simultaneous kidney pancreas transplants. Transplant rates increased in 2016, and mortality on the waiting list decreased. The declining enthusiasm for pancreas after kidney (PAK) transplants persisted. The uniform definition of graft failure was approved by the OPTN Board of Directors in 2015 and will be implemented in early 2018. Meanwhile, SRTR continues to refrain from reporting pancreas graft failure data. The OPTN/UNOS Pancreas Transplantation Committee is seeking to broaden allocation of pancreata across compatible ABO blood types in a proposal out for public comment July 31 to October 2, 2017. A new initiative to provide guidance on the benefits of PAK transplants is also out for public comment.

Sirolimus vs mycophenolate mofetil (MMF) in primary combined pancreas and kidney transplantation. Results of a long-term prospective randomized study

“…Patient survival was similar in both groups and in accordance with data presented by the International Pancreas Transplant Registry and various studies . Pancreas and kidney graft survival did not differ between groups, as similarly reported by Ciancio et al In contrast with this work, we randomized a larger number of recipients, thus improving statistical test power.…”

Peri‐graft porcine‐specific CD4+FoxP3+ regulatory T cells by CD40‐CD154 blockade prevented the rejection of porcine islet graft in diabetic mice

“…The immunosuppressant protocol consisted of injecting 0.5 mg of anti-CD154 mAb (MR1; Bio X Cell, West Lebanon, NH) per mouse ip on DPT 0, 1, 3, 5, and 7. For T reg depletion or neutralization of TGF-β, anti-CD25 mAb (PC61; Bio X Cell; 0.5 mg, ip, on DPT 28,30,32,34) or anti-TGF-β mAb (Bio X Cell; 0.5 mg, ip, on DPT 0, 2,4,6,8,10,12 or DPT 28,30,32,34,36,38,40) was used, respectively. Day 0 was defined as the time of islet transplantation procedure.…”

Three-month pancreas graft function significantly influences survival following simultaneous pancreas-kidney transplantation in type 2 diabetes patients

“…Type‐2 diabetes mellitus (T2DM) is the leading cause of ESRD in the United States and accounted for 45.9% of incident cases of kidney allograft failure from 2011 to 2015 . Currently, there are more than 15 000 patients with diabetes on the waiting list for kidney transplantation, but SPK in this cohort has been infrequently utilized . The poorly understood mechanism by which the transplanted pancreas overcomes insulin resistance along with the hypothetical risk of graft failure from β‐cell overstimulation and “exhaustion,” have likely contributed to the limited use of SPK in these patients.…”

“…7 Currently, there are more than 15 000 patients with diabetes on the waiting list for kidney transplantation, but SPK in this cohort has been infrequently utilized. 8 The poorly understood mechanism by which the transplanted pancreas overcomes insulin resistance along with the hypothetical risk of graft failure from β-cell overstimulation and "exhaustion,"…”