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The UK Pancreas Allocation Scheme for Whole Organ and Islet Transplantation

Lookup NU author(s): Professor James Shaw

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Abstract

In order to develop a national allocation scheme for donor pancreases, factors affecting waiting time and transplant outcomes in the United States (US) and United Kingdom (UK) were analyzed and compared. Blood group, sensitization, dialysis requirement, and whether the patient was waiting for a kidney and pancreas or pancreas alone affected waiting time in both countries; ethnicity and body mass index (BMI) also affected waiting time in the US. Ninety-day pancreas survival was similar in the UK and US, and was poorer for patients receiving a pancreas alone, with older donors, higher BMI and longer duration of ischemia in both countries. Factors affecting outcome, together with published data on factors affecting islet transplantation, informed the development of a points based allocation scheme for deceased donor pancreases in the UK providing equitable access for both whole organ and islet recipients through a single waiting list. Analysis of the allocation scheme 3 years after its introduction in December 2010 showed that the results were broadly as simulated, with a significant reduction in the number of long waiting patients and an increase in the number of islet transplants. There remains a surplus of highly sensitized patients in the waiting list, which the scheme should address in time.


Publication metadata

Author(s): Hudson A, Bradbury L, Johnson R, Fuggle SV, Shaw JAM, Casey JJ, Friend PJ, Watson CJE

Publication type: Article

Publication status: Published

Journal: American Journal Of Transplantation

Year: 2015

Volume: 15

Issue: 9

Pages: 2443-2455

Print publication date: 01/09/2015

Online publication date: 05/05/2015

Acceptance date: 23/02/2015

ISSN (print): 1600-6135

ISSN (electronic): 1600-6143

Publisher: Wiley-Blackwell Publishing Inc.

URL: http://dx.doi.org/10.1111/ajt.13284

DOI: 10.1111/ajt.13284


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