UNOS Perspective on Pancreas Transplantation

Abstract

The Organ procurement and Transplantation Network (OPTN) develops pancreas transplant allocation policy under Federal Government contract from the Health Resources and Services Administration (HRSA). This system was established when Congress passed the National Organ Transplantation Act (NOTA) in 1984. OPTN data are collected by the United Network for Organ Sharing (UNOS) for outcomes analysis and transplant program oversight. Despite improving clinical results, the number of pancreas transplants done in the United States has seen a significant decline over the past 10 years. There have also been declines in the number of additions to the pancreas transplant waiting list. This may be in part related to changes in the medical management of diabetes and changes in the organ donor population. In 2014 a new OPTN pancreas allocation system was instituted. Prior to this pancreas allocation varied with respect to how pancreas allocation integrated with kidney allocation. A uniform definition of pancreas allograft failure has also been developed which will be used to report pancreas graft and patient outcome by the Scientific Registry of Transplant Recipients (SRTR). The OPTN continues to work to devise policy strategies with a goal to remove structural barriers to pancreas transplantation and improve data collection.