Introduction: Pancreas transplantation (PTx) remains the only strategy for reinstitution of long-term insulin production and outcomes have progressively improved. Yet, historically, centers have employed age-limits for PTx candidates.

Methods: A single-center, retrospective-study of adult, deceased-donor simultaneous-pancreas and kidney (SPK) and solitary-pancreas (SP, incl. PAK and PTA) recipients 55-or-greater (55+), occurring from 1999-2013 was performed. Comparison groups were: group 1 (n=28): aged 55+ PTx, group 2 (n=545): aged 35-44 PTx, group 3 (n=167): aged 25-34 PTx, group 4 (n=260) was an age-matched control (55+) comprised of kidney transplant (KTx) recipients.

Results: Within study parameters, 1000 patients underwent PTx. In groups 1-3, 11, 405, and 136 were SPKs vs 17, 140, and 31 SPs, respectively. Five and 10-year patient survivals (PS) were 78.3%, 88.9%, and 90.8% vs 50.4%, 80.3%, and 77.5% for groups 1-3, respectively (p<0.01). There was no difference in PS for group 1 vs 2 (p=0.08), 2 vs 3 (p=0.90), or 1 vs 3 (p=0.07). Regarding pancreatic grafts, one and 5-year graft survival (GS) was 78.6%, 88.1%, and 85.0% vs 57.8%, 74.1%, and 66.2% for groups 1-3; Ten-year pancreas GS for groups 1-3 were 30.8%, 59.8%, and 45.1% (p=0.01), respectively. Pairwise comparison (PC) of group 1 vs 2 GS revealed no difference (p=0.09). PC of pancreatic rejection revealed no difference between group 1 vs 2 or 3. Group 1 had more frequent cardiovascular (p=0.04) and technical complications (p=0.02). With regard to renal transplant recipients, there was no difference in PS between groups 1 and 4. Comparison of renal GS in the 11 group 1 SPK patients (26.9%) was no different than renal graft survival for patients in group 4.

Conclusions: PTx recipients aged 55+ had acceptable long-term PS and GS. Additionally, type of organ transplant did not correlate with patient survival in 55+ patients. Chronological age alone should not exclude a patient for PTx candidacy.

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