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Improving pancreas graft utilization through importation
Authors:Julia Torabi  Juan P Rocca  Krystina Choinski  Katherine Lorenzen  Camille Yongue  Michelle L Lubetzsky  Melvon E Herbert  Attasit Chokechanachaisakul  Maria Ajaimy  Layla Kamal  Enver Akalin  Milan Kinkhabwala  Jay A Graham
Institution:1. Albert Einstein College of Medicine, Bronx, NY, USA;2. Montefiore‐Einstein Center for Transplantation, Montefiore Medical Center, Bronx, NY, USA;3. Case Western Reserve University School of Medicine, Cleveland, OH, USA
Abstract:

Background

We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation.

Methods

This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost‐effectiveness of this strategy.

Results

Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P = .001, PL 563 vs 157 u/L; P = .023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney‐pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P = .038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs.

Conclusions

Imported pancreas grafts may be a cost‐effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.
Keywords:organ acceptance  organ procurement  Organ Procurement and Transplantation Network  organ procurement organization
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