Improving pancreas graft utilization through importation

Julia Torabi; Juan P. Rocca; Krystina Choinski; Katherine Lorenzen; Camille Yongue; Michelle L. Lubetzsky; Melvon E. Herbert; Attasit Chokechanachaisakul; Maria Ajaimy; Layla Kamal; Enver Akalin; Milan Kinkhabwala; Jay A. Graham

doi:10.1111/ctr.13154

Improving pancreas graft utilization through importation

Julia Torabi, Juan P. Rocca, Krystina Choinski, Katherine Lorenzen, Camille Yongue, Michelle L. Lubetzsky, Melvon E. Herbert, Attasit Chokechanachaisakul, Maria Ajaimy, Layla Kamal, Enver Akalin, Milan Kinkhabwala, Jay A. Graham

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. Methods: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost-effectiveness of this strategy. Results: Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P =.001, PL 563 vs 157 u/L; P =.023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney-pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P =.038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs. Conclusions: Imported pancreas grafts may be a cost-effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.

Original language	English (US)
Article number	e13154
Journal	Clinical Transplantation
Volume	32
Issue number	1
DOIs	https://doi.org/10.1111/ctr.13154
State	Published - Jan 2018

Keywords

Organ Procurement and Transplantation Network
organ acceptance
organ procurement
organ procurement organization

ASJC Scopus subject areas

Transplantation

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10.1111/ctr.13154

Cite this

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title = "Improving pancreas graft utilization through importation",

abstract = "Background: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. Methods: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost-effectiveness of this strategy. Results: Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P =.001, PL 563 vs 157 u/L; P =.023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney-pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P =.038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs. Conclusions: Imported pancreas grafts may be a cost-effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.",

keywords = "Organ Procurement and Transplantation Network, organ acceptance, organ procurement, organ procurement organization",

author = "Julia Torabi and Rocca, {Juan P.} and Krystina Choinski and Katherine Lorenzen and Camille Yongue and Lubetzsky, {Michelle L.} and Herbert, {Melvon E.} and Attasit Chokechanachaisakul and Maria Ajaimy and Layla Kamal and Enver Akalin and Milan Kinkhabwala and Graham, {Jay A.}",

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year = "2018",

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doi = "10.1111/ctr.13154",

language = "English (US)",

volume = "32",

journal = "Clinical Transplantation",

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T1 - Improving pancreas graft utilization through importation

AU - Torabi, Julia

AU - Rocca, Juan P.

AU - Choinski, Krystina

AU - Lorenzen, Katherine

AU - Yongue, Camille

AU - Lubetzsky, Michelle L.

AU - Herbert, Melvon E.

AU - Chokechanachaisakul, Attasit

AU - Ajaimy, Maria

AU - Kamal, Layla

AU - Akalin, Enver

AU - Kinkhabwala, Milan

AU - Graham, Jay A.

PY - 2018/1

Y1 - 2018/1

N2 - Background: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. Methods: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost-effectiveness of this strategy. Results: Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P =.001, PL 563 vs 157 u/L; P =.023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney-pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P =.038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs. Conclusions: Imported pancreas grafts may be a cost-effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.

AB - Background: We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation. Methods: This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost-effectiveness of this strategy. Results: Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P =.001, PL 563 vs 157 u/L; P =.023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney-pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P =.038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs. Conclusions: Imported pancreas grafts may be a cost-effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.

KW - Organ Procurement and Transplantation Network

KW - organ acceptance

KW - organ procurement

KW - organ procurement organization

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Improving pancreas graft utilization through importation

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