Pancreas Graft Failure Definition Update
The Pancreas Transplantation Committee addresses the lack of a standardized definition for pancreas graft failure, impacting reporting and patient outcomes. A proposed definition, feedback, and public comments aim to improve clarity and consistency in assessing graft status. Explore the implications and considerations in defining graft failure for transplant patient safety.
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Presentation Transcript
Pancreas Transplantation Committee Update: Definition of Pancreas Graft Failure Jonathan Fridell, MD, Chair
Strategic Plan Goal: Promote transplant patient safety
Problem No nationally, consistently used definition for pancreas graft failure Leads to inconsistent reporting impacts MPSC outcome reviews
Status Proposal for the Definition of Pancreas Graft Failure Currently posted for public comment: September 29 December 5, 2014 Board Consideration: June 2015 (Estimated)
Current Tiedi Guidance Functioning: The graft has sufficient function so that the recipient is NOT receiving any insulin or oral medication for blood sugar control. Partial Function: The patient is taking some insulin, but < 50% of the usual amount taken before transplant, or C-Peptide is present. Failed: The graft has totally failed and the patient is completely dependent upon insulin or oral medication for blood sugar control.
Proposed Definition of Pancreas Graft Failure One of the following: recipient s transplanted pancreas is removed recipient re-registers for a pancreas recipient registers for an islet transplant after receiving a pancreas transplant recipient s insulin use is greater than or equal to 0.5 units/kg/day for a consecutive 90 days recipient dies
Public Comment Feedback Overall support with some opposition Several questions regarding insulin threshold
Proposals Specific Request for Feedback Policy 1.2 Definitions Graft failure: Occurs when an organ is removed, a recipient dies, or a recipient is placed on a chronic allograft support system. Should there be one general definition for graft failure that applies across all organ types? Alternatively, should there be organ specific definitions of graft failure?
Questions? Thank you! Jonathan Fridell, MD, Committee Chair jfridell@iupui.edu Kristina Tyler JD, Committee Liaison Kristina.Tyler@unos.org
