Summary

This analysis of pancreas transplant recipient cases reported to the IPTR and UNOS, (nearly 18,000), showed strikingly progressive improvement in outcome over time from 1987-2002. There were no significant differences in outcomes between US cases (>12,900) and non-US cases (>4,900). Most cases were SPK, but solitary transplants have risen in recent years, especially PAK. The PAK group had the largest number of retransplants (n=346, 32% of total), the majority of which were done after isolated pancreas graft failure in SPK. Overall, the 1996-2002 outcome for pancreas transplantation was excellent for patient, pancreas and kidney graft survival in all categories. Non-US and US pancreas transplant results were basically similar.

While cadaver pancreas transplants still show some under-utilization, the number has increased annually since the 1980's. Kidney allocation has affected SPK transplants, which have reached a plateau. However, solitary transplants continue to be on the rise. From 1998-2001, the absolute increase in PAK was double the absolute decline in SPK. The number of PTA transplants nearly doubled as well. Even though the current utilization rate is ~25%, the trend is for continuing beta-cell replacement growth, whether by islet transplant or whole organ pancreas transplantation. Beta-cell replacement should be used to its full potential as a principal procedure to aid diabetic individuals in reaching their goal of achieving insulin-independence.