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Where Have All the Pancreas Transplants Gone and What Needs to Change?

  • Jon S. OdoricoEmail author
  • Matthew Cooper
  • Ty B. Dunn
Kidney Transplantation (M Henry and R Pelletier, Section Editors)
  • 11 Downloads
Part of the following topical collections:
  1. Topical Collection on Kidney Transplantation

Abstract

Purpose of Review

To shed light on the multiple factors impacting a decline in pancreas transplant volume and to present strategies that individual transplant centers can implement to increase their volumes.

Recent Findings

Overall, pancreas transplant volume is declining in the USA and in several other countries of the world. The reasons are multifactorial, but an important driving factor is the delayed progression to end-stage renal disease in patients with type 1 diabetes due to better diabetes care. Another factor contributing to the lack of expansion of the pancreas transplant field is an under appreciation by the endocrinology and medical communities that pancreas transplantation offers excellent results that are now substantially improved over historic outcomes. Compounding these trends, there appears to be a continual negative cycle of low volume at many training centers leading to inadequate training, which then results in a lack of confidence and expertise in practicing surgical faculty and inpatient transplant units.

Summary

Of all types of solid organ transplants, pancreas transplantation is unique in that as outcomes have improved over the last several decades, the number of pancreas transplants performed is declining. We discuss the reasons underlying the declining numbers and will highlight specific strategies that can be implemented at centers to increase individual pancreas transplant center volumes.

Keywords

Pancreas transplantation Outcomes Diabetes End-stage renal disease Diabetic nephropathy Trends 

Notes

Acknowledgments

We would like to express our sincere gratitude to Read Urban and Sharon Shepard of UNOS for providing data related to pancreas program reviews.

Compliance with Ethical Standards

Conflict of Interest

Jon Odorico, Matthew Cooper and Ty Dunn declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Transplantation, Department of SurgeryUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonUSA
  2. 2.Medstar Georgetown Transplant Institute and Georgetown University School of MedicineWashingtonUSA
  3. 3.Penn Transplant Institute, Perelman School of MedicineHospital of the University of PennsylvaniaPhiladelphiaUSA

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