Improving pancreas graft utilization through importation

Clin Transplant. 2018 Jan;32(1). doi: 10.1111/ctr.13154. Epub 2017 Dec 11.

Abstract

Background: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation.

Methods: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost-effectiveness of this strategy.

Results: Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P = .001, PL 563 vs 157 u/L; P = .023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney-pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P = .038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs.

Conclusions: Imported pancreas grafts may be a cost-effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.

Keywords: Organ Procurement and Transplantation Network; organ acceptance; organ procurement; organ procurement organization.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cold Ischemia*
  • Female
  • Follow-Up Studies
  • Graft Survival*
  • Humans
  • Male
  • Pancreas Transplantation / methods*
  • Patient Selection*
  • Prognosis
  • Retrospective Studies
  • Tissue Donors
  • Tissue and Organ Procurement / methods*
  • Travel
  • Waiting Lists
  • Young Adult