Background: Due in part to the recently revised pancreas allocation system, patients who are listed for simultaneous pancreas and kidney (SPK) transplantation can be transplanted very quickly and with high-quality organs. Despite this, the rate of pancreas transplantation in the United States remains lower than it was a decade ago. In contrast to a historical surgeon-centric approach, we hypothesized that a protocoled multidisciplinary strategy to pancreas candidate triage might lead to an increased rate of SPK evaluation and transplantation

Methods: We first performed a retrospective review of our center's kidney transplant waiting list to identify missed opportunities for SPK. Informed by this analysis, our multi-disciplinary team implemented a pilot study of protocoled pancreas transplant triage and evaluation. Rates of transplant evaluation and pancreas transplantation were analyzed.

Results: Over 2.4 years, 62 insulin dependent diabetic patients could have been listed for a pancreas transplant. Accordingly, a pilot study of enhanced pancreas transplant screening was implemented. During the pilot study, 31 SPKs were transplanted. Thirty-day graft survival was 96.8%. Pancreas transplant evaluation rates increased from 0.71 per month prior the pilot program's implementation to 3.54 per month after implementation (p<0.001). Further, rates of pancreas transplantation increased from 0.85 per month prior to implementation to 2.30 per month after the pilot's implementation (p=0.035). The rate of transplantation increased from 1.25 transplants per month early in the study period to 3.0 transplants per month later in the study period (p<0.012).

Conclusions: Pancreas transplantation remains an excellent option for diabetic patients with renal failure and outcomes are outstanding. A multi-disciplinary approach to pancreas transplant candidacy led to increased rates of evaluation and transplantation. Using a team based approach, it may be possible to overcome the “crisis” of decreased volumes in pancreas transplantation in the United States.

CITATION INFORMATION: Scalea J., Bartlett S., Barth R. Addressing the “Crisis” in Pancreas Transplant Volume Using a Multidisciplinary Approach Am J Transplant. 2017;17 (suppl 3).

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