Analysis of United States pancreas transplant registry data

From October, 1987 to July, 1993, 2,497 pancreas transplants in the United States were reported to the International Pancreas Transplant and United Network for Organ Sharing Scientific Registry, including 2,130 simultaneous with a kidney (SPK), 207 after a kidney (PAK) and 148 alone in nonuremic recipients (PTA). Bladder drainage was used for 96% of the cases. Overall, patient and pancreas graft survival rates at 1 year were 91% and 72%. There were no differences in the patient survival rates by recipient category, but there was for graft survival rates. At 1 year, 76% of SPK, 48% of PAK, and 51% of PTA grafts were functioning. Patient age, gender, preservation time up to 30 hours, and induction immunosuppression regimens did not influence graft survival rates. HLA matching did not effect SPK results, but PTA and PAK cases with 0-1 mismatches had graft survival rates equivalent to those of SPK recipients. Registry data shows a high success rate with SPK transplants, and suggests that the results of solitary pancreas transplants could be improved by more emphasis on HLA matching.