A Decade of Pancreas Transplantation—A Registry Report

Since the first pancreas transplant in 1966, over 67,000 pancreas transplants have been performed worldwide and the number is growing. While the number of transplants in the US has changed only slightly over the past decade, many countries outside the US have shown strong growth in transplant numbers. The worldwide growth in numbers is due to the increasing number of patients with type 2 diabetes mellitus receiving a pancreas transplant. Only during the COVID-19 pandemic in 2020 and 2021 did transplant numbers decline, but they started to recover in 2022. The decline was especially noted for solitary transplants. This development over time was due to excellent patient and graft survival after simultaneous pancreas and kidney transplant (SPK). Patient survival at three years was >90% in SPK as well as in solitary transplants. At 3 years post-transplant, SPK pancreas graft survival was over 86% and SPK kidney graft survival over 90%. In pancreas transplants alone (PTA) and in pancreas after kidney transplants, the 3-year graft function reached 75%. The main reasons for advancement in outcome were reductions in technical failures and immunological graft losses. These improvements were due to better patient and donor selection, standardization of surgical techniques, and superior immunosuppressive protocols.