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

Goal: Increase the number of transplants Strategic Plan

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

All Pancreas Transplant Types, longitudinal trends from 2000 through 2013

Reasons for PA Discard Era 1 1/1/02 – 12/31/03 Era 2 7/1/12 – 6/30/14 Not reported10.8% (N = 86)0.2% (N = 1) Poor organ function9.8% (78)7.5% (50) Anatomical Abnormalities 17.0% (135)21.7% (144) No recipient located – list exhausted 9.3% (74)14.2% (94) Other, specify20.5% (163)34.2% (227) Notable PA Discard Reasons: Deceased Donors recovered in the US from 1/1/ /31/03 and 7/1/12 - 6/30/14

Reasons for PA Discard Era 1 1/1/02 – 12/31/03 Era 2 7/1/12 – 6/30/14 Other Specify12.7% (N = 165)8.2% (N = 89) Poor Organ Function18.4% (239)7.8% (85) No Recipient Located 6.6% (86)9.6% (104) Organ Refused By All National Program 2.0% (26)16.8% (183) Ruled Out After Evaluation in OR 7.1% (92)24.8% (270) Notable PA Not Recovered Reasons: Deceased Donors recovered in the US from 1/1/ /31/03 and 7/1/12 - 6/30/14

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 Preliminary Findings

Thank you! Jonathan Fridell, MD, Committee Chair Kristina Tyler JD, Committee Liaison Questions?

Back-up Slides

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)