An Economic Analysis of the UK Pancreas Allocation Scheme
1The Renal and Pancreas Transplantation Unit, Manchester Royal Infirmary, Manchester, United Kingdom
2Centre for Health Economics, University of Manchester, Manchester, United Kingdom
3Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Meeting: 2018 American Transplant Congress
Abstract number: B342
Keywords: Allocation, Ethics, Islets, Pancreas
Session Information
Session Name: Poster Session B: Non-Organ Specific: Economics, Public Policy, Allocation, Ethics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: Economics provides input to decisions concerning the best use of available resources. In transplantation, limitations include organ availability and competing organ demands. This is particularly evident in beta cell replacement. An analytical framework is presented for the allocation of a fixed supply of pancreata to be shared between solid pancreas and islet transplants according to national allocation criteria.
Methods: We consider the mean number of organs retrieved per solid pancreas and islet transplant, and the number of transplants per patient. Using retrieval allocation data from NHSBT, we estimate the rate of transformation (or trade-off) between procedures.
Results: Between 01/04/08 and 31/03/2016, 3294 pancreata were retrieved for solid organ and islet cell transplantation. 2551 went into the solid organ pathway, with 1606 transplants (62.95% conversion). 743 went into the islet pathway, with 183 transplants (24.62% conversion). With each patient requiring two islet transplants, 12.5 patients can be treated. In the context of an available supply of 100 pancreata, around 25 islet transplants could be performed. For solid pancreata, the same organ supply would allow 63 transplants. So for every islet recipient, the same organs could be used on average for 5 solid pancreas transplant recipients. The mean outcome per islet patient is freedom from hypoglycaemia unawareness, and for solid organ transplant it is freedom from insulin. A cost analysis found islet transplants to be more expensive than solid pancreata per patient.
Discussion: The allocation of a restricted supply of organs presents many clinical, economic and ethical challenges. These estimates identify the trade-offs involved in organs allocation. While clinical priorities are paramount in allocation policies, economic estimates provide an indication of the 'price' or opportunity cost of considerations that can help inform decisions makers, aimed at the efficient use of organs and the equitable treatment of different patient groups.
CITATION INFORMATION: Burke K., Birch S., Augustine T. An Economic Analysis of the UK Pancreas Allocation Scheme Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Burke K, Birch S, Augustine T. An Economic Analysis of the UK Pancreas Allocation Scheme [abstract]. https://atcmeetingabstracts.com/abstract/an-economic-analysis-of-the-uk-pancreas-allocation-scheme/. Accessed May 9, 2025.« Back to 2018 American Transplant Congress