*Purpose: The Organ Procurement and Transplantation Network (OPTN) proposed a new national deceased donor pancreas allocation policy that removes donor service area and OPTN region as units of allocation in order to comply with the Federal Final Rule.

*Methods: The Scientific Registry of Transplant Recipients simulated the distribution of pancreata under the new policy scenarios compared with current allocation policy. The new policy scenarios include three different-sized concentric circles of 150, 250, and 500 nautical miles around the donor hospital and linearly assigned proximity points within and outside the circle to minimize organ travel distance.

*Results: Figure1 describes the simulated distribution of organ travel distance. Circle size was the most important determinant of travel distance. Proximity points affected the travel distance within the circle but not outside it. Kidney-pancreas transplant rates increased for female, African American, non-Latino, and highly sensitized candidates. Pancreas-alone transplant rates decreased globally under broader sharing. Pancreas-alone candidates aged ≥35 years or with calculated panel-reactive antibodies (cPRA) ≥80% underwent slightly more transplants than those aged <35 years or with cPRA <80%.

*Conclusions: Simulations of proposed pancreas policy suggest improved access to kidney-pancreas transplant for several categories of vulnerable populations. Figure 1: Distribution of organ travel distance for kidney-pancreas (Panel A) and pancreas-alone transplants (Panel B). The different scenarios are described by circle size and proximity points for candidates within and outside the circle. BL represents the baseline or current allocation policy. Step 150 represents set proximity points awarded up to 150 miles and then declining linearly to zero at 500 miles from the donor hospital.Panel A:

Panel B:

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