Effect of Center Size on USA Pancreas Transplant Outcome for 1999 - 2003

Large centers were defined as >100 pancreas transplants from 1999 to 2003: 4,866 in large centers (n=21) vs. 4,120 in small centers (n=113). For 1999-2003 DD primary pancreas transplants, there was a small significant difference by center size for 1-year SPK patient and graft survival rates: large centers 86% (n=1852) vs. small centers 84% (n=1923) (Wilcoxon p=0.08 Log-Rank p=0.03). PAK 1-year survival rates were similar: both large (n=498) and small (n=453) centers 78%; but long-term did show differences, although not significant: 3-year GSRs large centers 68% vs. small centers 55%.  PTA 1-year patient survival rates were significantly higher at large centers: 1-year GSRs 80% large centers (n=321) vs. 71% small centers (n=82) (p=0.03). Small centers did more total SPKs than large centers, which tended to have more comprehensive programs with all categories (SPK, PAK, PTA); this increases the probability for higher PTA GSR outcome in large centers.

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