Where Have All the Pancreas Transplants Gone and What Needs to Change?

AbstractPurpose of ReviewTo shed light on the multiple factors impacting a decline in pancreas transplant volume and to present strategies that individual transplant centers can implement to increase their volumes.Recent FindingsOverall, pancreas transplant volume is declining in the USA and in several other countries of the world. The reasons are multifactorial, but an important driving factor is the delayed progression to end-stage renal disease in patients with type 1 diabetes due to better diabetes care. Another factor contributing to the lack of expansion of the pancreas transplant field is an under appreciation by the endocrinology and medical communities that pancreas transplantation offers excellent results that are now substantially improved over historic outcomes. Compounding these trends, there appears to be a continual negative cycle of low volume at many training centers leading to inadequate training, which then results in a lack of confidence and expertise in practicing surgical faculty and inpatient transplant units.SummaryOf all types of solid organ transplants, pancreas transplantation is unique in that as outcomes have improved over the last several decades, the number of pancreas transplants performed is declining. We discuss the reasons underlying the declining numbers and will highlight specific strategies that can be implemented at centers to increase individual pancreas transplant center volumes.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research