BACKGROUND: Utilisation of pancreases for transplantation remains inferior to that of other organs. Herein we analysed UK pancreas discards to identify the reasons for the low utilisation rates.
METHODS: Data on all pancreases offered first for solid organ transplantation between 1st January 2005 and 31st December 2015 were extracted from the UK Transplant Registry. The number of organs discarded, reasons and the time point of discard were analysed. A centre specific comparison was also undertaken.
RESULTS: 7367 pancreases were offered first for solid organ transplantation. 35% were Donors after circulatory death (DCD). 3668 (49.7%) organs were not retrieved. Of the 3699 pancreases retrieved, 38% were initially accepted but subsequently discarded. 2145 (29%) grafts offered were transplanted as simultaneous pancreas-kidney or solitary pancreas. 1177 (55%) were transplanted on the first offer whilst the remaining 968 were transplanted after a median of 3 offers. 52% DBD pancreases were accepted and transplanted on the first offer compared with 68% DCD grafts. There were significant differences in discard rates between centres (30-80% for DBD and 3-78% for DCD, p<0.001).
CONCLUSIONS: A significant number of solid pancreases are discarded. Better graft assessment at retrieval could minimise unnecessary organ travel and discards. Closer links with islet programs may allow for better utilisation of discarded grafts.