Singh Neeraj, Stratta Robert J
John C. McDonald Regional Transplant Center, Shreveport, Louisiana, USA.
Department of Surgery, Atrium Health Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Clin Transplant. 2023 Dec;37(12):e15148. doi: 10.1111/ctr.15148. Epub 2023 Oct 4.
The number of solid organ pancreas transplants performed in the United States has declined over the past two decades despite improving outcomes and the known benefits associated with this procedure. Although the reasons are multifactorial, high rates of deceased donor pancreata nonrecovery and nonuse have at least in part contributed to the reduction in pancreas transplant activity. The pancreas has higher nonrecovery and nonuse rates compared to the kidney and liver because of more stringent donor selection criteria, particularly with respect to donor age and body mass index, although even marginally inferior donor pancreata likely still benefit some patients compared to alternative therapies. In this editorial, we present several donor-, candidate-, and center-specific factors that are either confirmed or suspected of being associated with inferior outcomes, which contribute to high pancreas nonrecovery and nonuse rates. In addition, we have discussed several measures to increase pancreas recovery and reduce pancreas nonutilization.
在过去二十年中，尽管实体器官胰腺移植的效果有所改善且该手术具有已知的益处，但在美国进行的此类移植手术数量仍有所下降。尽管原因是多方面的，但已故供体胰腺未被回收和未被使用的高比例至少在一定程度上导致了胰腺移植活动的减少。由于供体选择标准更为严格，特别是在供体年龄和体重指数方面，胰腺的未被回收和未被使用比例高于肾脏和肝脏，尽管与替代疗法相比，即使是略微欠佳的供体胰腺可能仍会使一些患者受益。在这篇社论中，我们介绍了一些已被证实或怀疑与较差结果相关的供体、候选人和中心特定因素，这些因素导致了胰腺未被回收和未被使用的高比例。此外，我们还讨论了一些增加胰腺回收和减少胰腺未被利用的措施。
