When pancreata fly: Outcomes and lessons learned from the development of a Pancreas Transplant Import Program.

Abstract

To address long waitlist times and increase pancreas transplantation, our center has implemented a protocol for long-distance importation of pancreata. We conducted a retrospective review of pancreas transplantation at our institution from January 1, 2014, the start of our importation program, through September 30, 2021. Outcomes were compared between locally procured grafts and imported grafts, defined as grafts procured greater than 250 nautical miles (NM) from our center. Eighty-one patients underwent pancreas transplantation during the study time period; 19 (23.5%) received imported grafts. There were no significant differences in recipient demographics or type of transplant received. Mean distance of import was 644.2±234.0 NM. Imported grafts were more likely to be from pediatric donors<18 years old (p=.02) and a significantly higher proportion of imported grafts came from donors weighing<30kg (26.3vs. 3.2%, p=.007). Cold ischemic time was longer for imported grafts than for local grafts (13.4±2.3 h vs. 9.8±2.2 h, p<.01). There was no significant difference in deaths or graft losses within 90 days or at 1 year between groups. Centers should consider expanding criteria for acceptance of imported pancreata to increase the number of transplants and combat organ nonutilization.