Pancreas Transplantation Committee Update: Addressing Underutilization

The Pancreas Transplantation Committee, led by Dr. Jonathan Fridell, aims to increase the number of transplants by investigating reasons for the reduction in pancreas transplants. They have made updates to the facilitated pancreas allocation policy and process, analyzing longitudinal trends from 2000 to 2013. Preliminary findings show a decline in pancreas transplant activity since the early 2000s, not solely due to transplant reductions or discards, with the waiting list size also decreasing. Contact details for inquiries are provided.

• Pancreas Transplantation
• Underutilization Project
• Transplant Trends
• Organ Allocation
• Committee Updates

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1. Pancreas Transplantation Committee Update: Pancreas Underutilization Project Jonathan Fridell, MD, Chair

2. Strategic Plan Goal: Increase the number of transplants

3. Objective Investigate reasons for reduction in PA transplants Updates to facilitated PA allocation policy and process

4. All Pancreas Transplant Types, longitudinal trends from 2000 through 2013

5. Notable PA Discard Reasons: Deceased Donors recovered in the US from 1/1/02 - 12/31/03 and 7/1/12 - 6/30/14 Reasons for PA Discard Era 1 Era 2 1/1/02 12/31/03 7/1/12 6/30/14 Not reported 10.8% (N = 86) 0.2% (N = 1) Poor organ function 9.8% (78) 7.5% (50) Anatomical Abnormalities 17.0% (135) 21.7% (144) No recipient located list exhausted Other, specify 9.3% (74) 14.2% (94) 20.5% (163) 34.2% (227)

6. Notable PA Not Recovered Reasons: Deceased Donors recovered in the US from 1/1/02 - 12/31/03 and 7/1/12 - 6/30/14 Reasons for PA Discard Era 1 Era 2 1/1/02 12/31/03 7/1/12 6/30/14 Other Specify 12.7% (N = 165) 8.2% (N = 89) Poor Organ Function 18.4% (239) 7.8% (85) No Recipient Located 6.6% (86) 9.6% (104) Organ Refused By All National Program Ruled Out After Evaluation in OR 2.0% (26) 16.8% (183) 7.1% (92) 24.8% (270)

7. Preliminary Findings PA transplant activity peaked in early 2000s and has been on the decline since approximately 2005 Decline has not been driven solely by the decrease in PA transplants or rise in PA discards Overall waiting list size and annual additions to the waiting list have both steadily decreased

8. Questions? Thank you! Jonathan Fridell, MD, Committee Chair jfridell@iupui.edu Kristina Tyler JD, Committee Liaison Kristina.Tyler@unos.org

9. Back-up Slides

10. Deceased donors recovered in the US from 1/1/2002 and 12/31/2003 or 7/1/2012 through 6/30/2014 that had at least 1 organ recovered for transplant who had their pancreas recovered for transplant and not transplanted (discarded). The distribution for discard reason is shown by era (1/1/2002 and 12/31/2003 or 7/1/2012 through 6/30/2014)