The rationale for the new deceased donor pancreas allocation schema

Mark D Stegall, Patrick G. Dean, Randall Sung, Mary K. Guidinger, Maureen A. McBride, Cindy Sommers, Giacomo Basadonna, Peter G. Stock, Alan B. Leichtman

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

BACKGROUND. To ensure the continued success of whole organ pancreas and islet transplantation, deceased donor pancreas allocation policy must continue to evolve. METHODS. To assess the existing system, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing Kidney and Pancreas Transplant Committee retrospectively analyzed the disposition and outcomes of deceased donor pancreata in the United States between January 1, 2000 and December 31, 2003. RESULTS. During the time period studied, consent was obtained but the pancreas was not recovered in 48% (11,820) of organ donors. The most common reasons given for nonrecovery were poor quality of the pancreas and difficulty in placement. Of whole organ pancreata that were transplanted, 90% were from donors with a body mass index (BMI) ≤30 kg/m and age ≤50 years. Pancreata from older and more obese donors were used more often for islet transplantation or research. For simultaneous pancreas-kidney transplants, the 1- and 3-year pancreas graft survival was lower when the donor was age >50 years (P=0.04), and there were trends toward lower graft survival with donor BMI >30 (P=0.06) and increasing cold-ischemia time. CONCLUSIONS. Based on these data, the OPTN adopted a new allocation algorithm in which pancreata from donors >30 kg/m or >50 years of age are, unless accepted for a local whole organ pancreas transplant candidate, preferentially allocated for islet transplantation. These data also suggest that many good quality pancreata are not procured, emphasizing the need for improved communication and cooperation between organ procurement organizations and pancreas and islet transplant programs.

Original languageEnglish (US)
Pages (from-to)1156-1161
Number of pages6
JournalTransplantation
Volume83
Issue number9
DOIs
StatePublished - May 2007

Fingerprint

Pancreas
Tissue Donors
Islets of Langerhans Transplantation
Organ Transplantation
Transplants
Tissue and Organ Procurement
Graft Survival
Body Mass Index
Kidney
Cold Ischemia
Pancreas Transplantation
Communication

Keywords

  • Islet transplantation
  • Organ allocation
  • Pancreas transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Stegall, M. D., Dean, P. G., Sung, R., Guidinger, M. K., McBride, M. A., Sommers, C., ... Leichtman, A. B. (2007). The rationale for the new deceased donor pancreas allocation schema. Transplantation, 83(9), 1156-1161. https://doi.org/10.1097/01.tp.0000261104.27113.05

The rationale for the new deceased donor pancreas allocation schema. / Stegall, Mark D; Dean, Patrick G.; Sung, Randall; Guidinger, Mary K.; McBride, Maureen A.; Sommers, Cindy; Basadonna, Giacomo; Stock, Peter G.; Leichtman, Alan B.

In: Transplantation, Vol. 83, No. 9, 05.2007, p. 1156-1161.

Research output: Contribution to journalArticle

Stegall, MD, Dean, PG, Sung, R, Guidinger, MK, McBride, MA, Sommers, C, Basadonna, G, Stock, PG & Leichtman, AB 2007, 'The rationale for the new deceased donor pancreas allocation schema', Transplantation, vol. 83, no. 9, pp. 1156-1161. https://doi.org/10.1097/01.tp.0000261104.27113.05
Stegall, Mark D ; Dean, Patrick G. ; Sung, Randall ; Guidinger, Mary K. ; McBride, Maureen A. ; Sommers, Cindy ; Basadonna, Giacomo ; Stock, Peter G. ; Leichtman, Alan B. / The rationale for the new deceased donor pancreas allocation schema. In: Transplantation. 2007 ; Vol. 83, No. 9. pp. 1156-1161.
@article{cc416d66aee04b7ea5545ba70466a2e5,
title = "The rationale for the new deceased donor pancreas allocation schema",
abstract = "BACKGROUND. To ensure the continued success of whole organ pancreas and islet transplantation, deceased donor pancreas allocation policy must continue to evolve. METHODS. To assess the existing system, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing Kidney and Pancreas Transplant Committee retrospectively analyzed the disposition and outcomes of deceased donor pancreata in the United States between January 1, 2000 and December 31, 2003. RESULTS. During the time period studied, consent was obtained but the pancreas was not recovered in 48{\%} (11,820) of organ donors. The most common reasons given for nonrecovery were poor quality of the pancreas and difficulty in placement. Of whole organ pancreata that were transplanted, 90{\%} were from donors with a body mass index (BMI) ≤30 kg/m and age ≤50 years. Pancreata from older and more obese donors were used more often for islet transplantation or research. For simultaneous pancreas-kidney transplants, the 1- and 3-year pancreas graft survival was lower when the donor was age >50 years (P=0.04), and there were trends toward lower graft survival with donor BMI >30 (P=0.06) and increasing cold-ischemia time. CONCLUSIONS. Based on these data, the OPTN adopted a new allocation algorithm in which pancreata from donors >30 kg/m or >50 years of age are, unless accepted for a local whole organ pancreas transplant candidate, preferentially allocated for islet transplantation. These data also suggest that many good quality pancreata are not procured, emphasizing the need for improved communication and cooperation between organ procurement organizations and pancreas and islet transplant programs.",
keywords = "Islet transplantation, Organ allocation, Pancreas transplantation",
author = "Stegall, {Mark D} and Dean, {Patrick G.} and Randall Sung and Guidinger, {Mary K.} and McBride, {Maureen A.} and Cindy Sommers and Giacomo Basadonna and Stock, {Peter G.} and Leichtman, {Alan B.}",
year = "2007",
month = "5",
doi = "10.1097/01.tp.0000261104.27113.05",
language = "English (US)",
volume = "83",
pages = "1156--1161",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - The rationale for the new deceased donor pancreas allocation schema

AU - Stegall, Mark D

AU - Dean, Patrick G.

AU - Sung, Randall

AU - Guidinger, Mary K.

AU - McBride, Maureen A.

AU - Sommers, Cindy

AU - Basadonna, Giacomo

AU - Stock, Peter G.

AU - Leichtman, Alan B.

PY - 2007/5

Y1 - 2007/5

N2 - BACKGROUND. To ensure the continued success of whole organ pancreas and islet transplantation, deceased donor pancreas allocation policy must continue to evolve. METHODS. To assess the existing system, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing Kidney and Pancreas Transplant Committee retrospectively analyzed the disposition and outcomes of deceased donor pancreata in the United States between January 1, 2000 and December 31, 2003. RESULTS. During the time period studied, consent was obtained but the pancreas was not recovered in 48% (11,820) of organ donors. The most common reasons given for nonrecovery were poor quality of the pancreas and difficulty in placement. Of whole organ pancreata that were transplanted, 90% were from donors with a body mass index (BMI) ≤30 kg/m and age ≤50 years. Pancreata from older and more obese donors were used more often for islet transplantation or research. For simultaneous pancreas-kidney transplants, the 1- and 3-year pancreas graft survival was lower when the donor was age >50 years (P=0.04), and there were trends toward lower graft survival with donor BMI >30 (P=0.06) and increasing cold-ischemia time. CONCLUSIONS. Based on these data, the OPTN adopted a new allocation algorithm in which pancreata from donors >30 kg/m or >50 years of age are, unless accepted for a local whole organ pancreas transplant candidate, preferentially allocated for islet transplantation. These data also suggest that many good quality pancreata are not procured, emphasizing the need for improved communication and cooperation between organ procurement organizations and pancreas and islet transplant programs.

AB - BACKGROUND. To ensure the continued success of whole organ pancreas and islet transplantation, deceased donor pancreas allocation policy must continue to evolve. METHODS. To assess the existing system, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing Kidney and Pancreas Transplant Committee retrospectively analyzed the disposition and outcomes of deceased donor pancreata in the United States between January 1, 2000 and December 31, 2003. RESULTS. During the time period studied, consent was obtained but the pancreas was not recovered in 48% (11,820) of organ donors. The most common reasons given for nonrecovery were poor quality of the pancreas and difficulty in placement. Of whole organ pancreata that were transplanted, 90% were from donors with a body mass index (BMI) ≤30 kg/m and age ≤50 years. Pancreata from older and more obese donors were used more often for islet transplantation or research. For simultaneous pancreas-kidney transplants, the 1- and 3-year pancreas graft survival was lower when the donor was age >50 years (P=0.04), and there were trends toward lower graft survival with donor BMI >30 (P=0.06) and increasing cold-ischemia time. CONCLUSIONS. Based on these data, the OPTN adopted a new allocation algorithm in which pancreata from donors >30 kg/m or >50 years of age are, unless accepted for a local whole organ pancreas transplant candidate, preferentially allocated for islet transplantation. These data also suggest that many good quality pancreata are not procured, emphasizing the need for improved communication and cooperation between organ procurement organizations and pancreas and islet transplant programs.

KW - Islet transplantation

KW - Organ allocation

KW - Pancreas transplantation

UR - http://www.scopus.com/inward/record.url?scp=34248386117&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34248386117&partnerID=8YFLogxK

U2 - 10.1097/01.tp.0000261104.27113.05

DO - 10.1097/01.tp.0000261104.27113.05

M3 - Article

C2 - 17496529

AN - SCOPUS:34248386117

VL - 83

SP - 1156

EP - 1161

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 9

ER -