The Implementation of the New Unos Policy That Relegates C-peptide and Body Mass Index Criteria Has Resulted in Shifting Recipient Demographics

R. Teo, A. Rechnitzer, N. A. Muhdi, J. Torabi, M. Ajaimy, L. Liriano-Ward, Y. Azzi, C. Pynadath, P. Loarte-Campos, A. Brooks, J. P. Rocca, M. Le, E. Akalin, J. A. Graham

Montefiore Medical Center, Bronx, NY

Meeting: 2021 American Transplant Congress

Abstract number: 491

Keywords: Donation, Kidney/pancreas transplantation, Pancreas

Topic: Administrative » Quality Assurance Process Improvement & Regulatory Issues

Session Information

Session Name: Quality Assurance Process Improvement & Regulatory Issues

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Waitlist time accrual for SPK was previously limited to candidates on insulin that had either a c-peptide ≤ 2 ng/ml, or a c-peptide > 2 ng/ml and a body mass index (BMI) ≤ 30 kg/m². As of July 11, 2019, these requirements were removed from the UNOS Pancreas Transplantation Committee Policy 11.3.B. The effect of this policy change on recipient demographics and outcomes has not been studied.

*Methods: An analysis of 76 SPK transplantations at Montefiore Medical Center from June 2014 to October 2020 was performed. SPK recipients pre- and post-policy change were compared. Endpoints included post-operative graft function and complications.

*Results: There were 51 SPK recipients before and 25 recipients after the policy change. There was a significant increase in the average age (38.9 v 46.2 years, p = .01), BMI (25.5 v 27.5 kg/m², p = .03), and c-peptide levels (1.7 v 4.5 ng/ml, p = .01) following the removal of BMI and c-peptide requirements. There were no significant differences in outcomes or rates of complications.

*Conclusions: The modification to the current policy expanded potential recipient demographic criteria while maintaining suitable outcomes. Our single center experience reflects the intended consequences of the adoption of the UNOS Pancreas Transplantation Committee Policy 11.3.B. This may prove to be beneficial for disadvantaged populations.

To cite this abstract in AMA style:

Teo R, Rechnitzer A, Muhdi NA, Torabi J, Ajaimy M, Liriano-Ward L, Azzi Y, Pynadath C, Loarte-Campos P, Brooks A, Rocca JP, Le M, Akalin E, Graham JA. The Implementation of the New Unos Policy That Relegates C-peptide and Body Mass Index Criteria Has Resulted in Shifting Recipient Demographics [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-implementation-of-the-new-unos-policy-that-relegates-c-peptide-and-body-mass-index-criteria-has-resulted-in-shifting-recipient-demographics/. Accessed May 16, 2025.

« Back to 2021 American Transplant Congress