Pancreas recovery has declined by 32% over 15yrs. We analyzed national pancreas utilization rates for donors with suitable criteria for pancreas retrieval to understand this trend

METHODS

Using UNOS database from 2000-14, we identified 31,960 potential suitable pancreas donors. Exclusion criteria: age>40, BMI>30kg/m², diabetes or alcohol history, positive serologies, liver/pancreas enzymes>500 and KDPI>85%. We compared pancreas utilization in 3 periods of 5yrs

RESULTS

Transplant rates have declined from 45.8 to 37.2% over time. Discard reasons that increased statistically include: donor quality(24.4 to 28.6%), unavailable recipients(9.1 to 12.6%) and DCD(2.5 to 5.5%). Other reasons remained similar: organ anatomy, no consent, CIT, shared vasculature, operational and CDT. Donor variables were statistically similar in the 3 periods

DISCUSSION

“Donor quality” for refusal code has significantly increased despite acceptable pancreas donation parameters. Possibly, some relevant information in “donor highlight” and “medical history” comments in donornet may not be captured in other discrete fields, including HbA1C. Calculated travel time may be a significant reason to refuse organs after retrieval. Kidney sharing for thoracic and abdominal teams may limit organs to PTA recipients making allocation difficult

CONCLUSION

Declining pancreas transplant rates may be due DCD refusal, donor quality and increased difficulty in organ allocation. Improvement in donornet documentation with discrete fields may help understand organ underutilization.

CITATION INFORMATION: Siddiqi S, Almario J, Villaroel-Gomez K, Yoo J, Blackburn C, Batra R, DiSabato D, Lu A, Akkina S, Desai A, Garcia-Roca R. Pancreas Organ Underutilization: 15-Year Analysis. Am J Transplant. 2017;17 (suppl 3).

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