Pancreas transplantation of US and Non-US cases from 2005 to 2014 as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR)

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

This report is an update of pancreas and kidney transplant activities in the US and non-US region in two periods, 2005- 2009 and 2010-2014. The aim of the report was to analyze transplant progress and success in the US compared to non- US countries, and to compare trends between the two periods. Between 2005-2009 and 2010-2014, the number of US pancreas transplants declined by over 20%, while the overall number of pancreas transplants performed outside the US has increased. The decline in US numbers is predominantly due to the decline in primary and secondary pancreas after kidney transplants (PAK). During the time period studied, the number of PAK transplants dropped by 50%. In contrast, the number of simultaneous pancreas/kidney transplants (SPK) declined by only 10%, and the number of pancreas transplants alone (PTA) by 20%. Over 90% of pancreas transplants worldwide were performed, with a simultaneous kidney transplant and excellent results. Transplant outcomes in SPK improved significantly because of a decrease in the rates of technical and immunologic graft loss. In 2010-2014 vs. 2005-2009, US SPK transplant patient survival at 1 year post-transplant increased from 95.7% to 97.4%, pancreas graft function from 88.3% to 91.3%, and kidney function from 93.6% to 95.5%. A significant improvement was also noted in PAK transplants. One-year patient survival increased from 96.4% to 97.9% and pancreas graft function from 81.0% to 86.0%. PTA 1-year patient survival remained constant at 97%, andpancreas 1-year graft survival improved from 81.0% to 85.7%. With the decline in the number of transplants, a change towards better pancreas donor selection was observed. In solitary transplants, the donors were primarily young trauma victims, and the pancreas preservation time was relatively short. A general tendency towards transplanting older recipients was noted. In 2010-2014 vs. 2005-2009, PTA recipients 50 years of age or older accounted for 32% vs. 22%, PAK for 28% vs. 22%, and SPK for 22% vs. 20%. This may be due to a relatively lower immunologic graft loss rate, especially in solitary transplants, which historically has been high in young recipients. The number of pancreas transplants in patients with type 2 diabetes and end-stage renal disease has increased, and accounted for 9% of all SPK recipients in 2010-2014.

Original languageEnglish (US)
Pages (from-to)35-58
Number of pages24
JournalReview of Diabetic Studies
Volume13
Issue number1
DOIs
StatePublished - Mar 1 2016

Fingerprint

Pancreas Transplantation
Registries
Pancreas
Transplants
Kidney

Keywords

  • Antibody induction
  • Diabetes
  • Graft function
  • Kidney
  • PAK
  • Pancreas transplant
  • PTA
  • SPK

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Internal Medicine

Cite this

@article{22bed22122c742ada7f7e72a50056a46,
title = "Pancreas transplantation of US and Non-US cases from 2005 to 2014 as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR)",
abstract = "This report is an update of pancreas and kidney transplant activities in the US and non-US region in two periods, 2005- 2009 and 2010-2014. The aim of the report was to analyze transplant progress and success in the US compared to non- US countries, and to compare trends between the two periods. Between 2005-2009 and 2010-2014, the number of US pancreas transplants declined by over 20{\%}, while the overall number of pancreas transplants performed outside the US has increased. The decline in US numbers is predominantly due to the decline in primary and secondary pancreas after kidney transplants (PAK). During the time period studied, the number of PAK transplants dropped by 50{\%}. In contrast, the number of simultaneous pancreas/kidney transplants (SPK) declined by only 10{\%}, and the number of pancreas transplants alone (PTA) by 20{\%}. Over 90{\%} of pancreas transplants worldwide were performed, with a simultaneous kidney transplant and excellent results. Transplant outcomes in SPK improved significantly because of a decrease in the rates of technical and immunologic graft loss. In 2010-2014 vs. 2005-2009, US SPK transplant patient survival at 1 year post-transplant increased from 95.7{\%} to 97.4{\%}, pancreas graft function from 88.3{\%} to 91.3{\%}, and kidney function from 93.6{\%} to 95.5{\%}. A significant improvement was also noted in PAK transplants. One-year patient survival increased from 96.4{\%} to 97.9{\%} and pancreas graft function from 81.0{\%} to 86.0{\%}. PTA 1-year patient survival remained constant at 97{\%}, andpancreas 1-year graft survival improved from 81.0{\%} to 85.7{\%}. With the decline in the number of transplants, a change towards better pancreas donor selection was observed. In solitary transplants, the donors were primarily young trauma victims, and the pancreas preservation time was relatively short. A general tendency towards transplanting older recipients was noted. In 2010-2014 vs. 2005-2009, PTA recipients 50 years of age or older accounted for 32{\%} vs. 22{\%}, PAK for 28{\%} vs. 22{\%}, and SPK for 22{\%} vs. 20{\%}. This may be due to a relatively lower immunologic graft loss rate, especially in solitary transplants, which historically has been high in young recipients. The number of pancreas transplants in patients with type 2 diabetes and end-stage renal disease has increased, and accounted for 9{\%} of all SPK recipients in 2010-2014.",
keywords = "Antibody induction, Diabetes, Graft function, Kidney, PAK, Pancreas transplant, PTA, SPK",
author = "Gruessner, {Angelika C} and Gruessner, {Rainer W G}",
year = "2016",
month = "3",
day = "1",
doi = "10.1900/RDS.2016.13.35",
language = "English (US)",
volume = "13",
pages = "35--58",
journal = "Review of Diabetic Studies",
issn = "1613-6071",
publisher = "Society for Biomedical Diabetes Research",
number = "1",

}

TY - JOUR

T1 - Pancreas transplantation of US and Non-US cases from 2005 to 2014 as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR)

AU - Gruessner, Angelika C

AU - Gruessner, Rainer W G

PY - 2016/3/1

Y1 - 2016/3/1

N2 - This report is an update of pancreas and kidney transplant activities in the US and non-US region in two periods, 2005- 2009 and 2010-2014. The aim of the report was to analyze transplant progress and success in the US compared to non- US countries, and to compare trends between the two periods. Between 2005-2009 and 2010-2014, the number of US pancreas transplants declined by over 20%, while the overall number of pancreas transplants performed outside the US has increased. The decline in US numbers is predominantly due to the decline in primary and secondary pancreas after kidney transplants (PAK). During the time period studied, the number of PAK transplants dropped by 50%. In contrast, the number of simultaneous pancreas/kidney transplants (SPK) declined by only 10%, and the number of pancreas transplants alone (PTA) by 20%. Over 90% of pancreas transplants worldwide were performed, with a simultaneous kidney transplant and excellent results. Transplant outcomes in SPK improved significantly because of a decrease in the rates of technical and immunologic graft loss. In 2010-2014 vs. 2005-2009, US SPK transplant patient survival at 1 year post-transplant increased from 95.7% to 97.4%, pancreas graft function from 88.3% to 91.3%, and kidney function from 93.6% to 95.5%. A significant improvement was also noted in PAK transplants. One-year patient survival increased from 96.4% to 97.9% and pancreas graft function from 81.0% to 86.0%. PTA 1-year patient survival remained constant at 97%, andpancreas 1-year graft survival improved from 81.0% to 85.7%. With the decline in the number of transplants, a change towards better pancreas donor selection was observed. In solitary transplants, the donors were primarily young trauma victims, and the pancreas preservation time was relatively short. A general tendency towards transplanting older recipients was noted. In 2010-2014 vs. 2005-2009, PTA recipients 50 years of age or older accounted for 32% vs. 22%, PAK for 28% vs. 22%, and SPK for 22% vs. 20%. This may be due to a relatively lower immunologic graft loss rate, especially in solitary transplants, which historically has been high in young recipients. The number of pancreas transplants in patients with type 2 diabetes and end-stage renal disease has increased, and accounted for 9% of all SPK recipients in 2010-2014.

AB - This report is an update of pancreas and kidney transplant activities in the US and non-US region in two periods, 2005- 2009 and 2010-2014. The aim of the report was to analyze transplant progress and success in the US compared to non- US countries, and to compare trends between the two periods. Between 2005-2009 and 2010-2014, the number of US pancreas transplants declined by over 20%, while the overall number of pancreas transplants performed outside the US has increased. The decline in US numbers is predominantly due to the decline in primary and secondary pancreas after kidney transplants (PAK). During the time period studied, the number of PAK transplants dropped by 50%. In contrast, the number of simultaneous pancreas/kidney transplants (SPK) declined by only 10%, and the number of pancreas transplants alone (PTA) by 20%. Over 90% of pancreas transplants worldwide were performed, with a simultaneous kidney transplant and excellent results. Transplant outcomes in SPK improved significantly because of a decrease in the rates of technical and immunologic graft loss. In 2010-2014 vs. 2005-2009, US SPK transplant patient survival at 1 year post-transplant increased from 95.7% to 97.4%, pancreas graft function from 88.3% to 91.3%, and kidney function from 93.6% to 95.5%. A significant improvement was also noted in PAK transplants. One-year patient survival increased from 96.4% to 97.9% and pancreas graft function from 81.0% to 86.0%. PTA 1-year patient survival remained constant at 97%, andpancreas 1-year graft survival improved from 81.0% to 85.7%. With the decline in the number of transplants, a change towards better pancreas donor selection was observed. In solitary transplants, the donors were primarily young trauma victims, and the pancreas preservation time was relatively short. A general tendency towards transplanting older recipients was noted. In 2010-2014 vs. 2005-2009, PTA recipients 50 years of age or older accounted for 32% vs. 22%, PAK for 28% vs. 22%, and SPK for 22% vs. 20%. This may be due to a relatively lower immunologic graft loss rate, especially in solitary transplants, which historically has been high in young recipients. The number of pancreas transplants in patients with type 2 diabetes and end-stage renal disease has increased, and accounted for 9% of all SPK recipients in 2010-2014.

KW - Antibody induction

KW - Diabetes

KW - Graft function

KW - Kidney

KW - PAK

KW - Pancreas transplant

KW - PTA

KW - SPK

UR - http://www.scopus.com/inward/record.url?scp=84983250210&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983250210&partnerID=8YFLogxK

U2 - 10.1900/RDS.2016.13.35

DO - 10.1900/RDS.2016.13.35

M3 - Article

C2 - 26982345

AN - SCOPUS:84983250210

VL - 13

SP - 35

EP - 58

JO - Review of Diabetic Studies

JF - Review of Diabetic Studies

SN - 1613-6071

IS - 1

ER -