Generating strategies for a national comeback in pancreas transplantation: A Delphi survey and US conference report

Workshop Participants, Ronald F. Parsons, Krista L. Lentine, Mona Doshi, Ty B. Dunn, Rachel Forbes, Jonathan A. Fridell, Michelle T. Jesse, Martha Pavlakis, Deirdre Sawinski, Neeraj Singh, David A. Axelrod, Matthew Cooper, Peter Abrams, Nada Alachkar, Tarek Alhamad, Nicole Ali, David Axelrod, Arpita Basu, Roy BloomGeorge Burke, Beatrice Concepcion, Rebecca Craig-Shapiro, Darshana Dadhania, Cinthia Drachenberg, Ty Dunn, Jonathan Fridell, John Friedewald, Osama Gaber, Rainer Gruessner, Angelika Gruessner, Michelle Josephson, Raja Kandaswamy, Dixon Kaufman, Yogish Kudva, Aleksandra Kukla, Vineeta Kumar, Yee Lu, Lisa McElroy, Nikole Neidlinge, Silke Niederhaus, Angie Nishio-Lucar, Jon Odorico, Sandesh Parajuli, Ronald Parsons, Stephen Pastan, Swati Rao, Lloyd Ratner, Giulio Romeo, Joseph Scalea, Marty Sellers, Dirk Slaker, Peter Stock, Robert Stratta, Nicole Turgeon, Piotr Witkowski, Kenneth Woodside, Anju Yadav

Research output: Contribution to journalArticlepeer-review

Abstract

In the United States, potential transplant candidates with insulin-dependent diabetes mellitus are inconsistently offered pancreas transplantation (PTx), contributing to a dramatic decline in pancreas allograft utilization over the past 2 decades. The American Society of Transplantation organized a workshop to identify barriers inhibiting PTx and to develop strategies for a national comeback. The 2-day workshop focused on 4 main topics: (1) referral/candidate selection, (2) organ recovery/utilization, (3) program performance/patient outcomes, and (4) enhanced education/research. Topics were explored through expert presentations, patient testimonials, breakout sessions, and strategic planning, including the identification of tasks for immediate focus. Additionally, a modified-Delphi survey was conducted among workshop members to develop and rate the importance of barriers, and the impact and feasibility of workgroup-identified improvement strategies. The panelists identified 16 barriers to progress and 44 strategies for consideration. The steps for a national comeback in PTx involve greater emphasis on efficient referral and candidate selection, better donor pancreas utilization practices, eliminating financial barriers to procurement and transplant, improving collaboration between transplant and diabetes societies and professionals, and increasing focus on PTx training, education, and research. Partnership between national societies, patient advocacy groups, and professionals will be essential to realizing this critical agenda.

Original languageEnglish
Pages (from-to)1473-1485
Number of pages13
JournalAmerican Journal of Transplantation
Volume24
Issue number8
DOIs
StatePublished - Aug 2024

Keywords

  • economics
  • education
  • efficiency
  • organ procurement
  • outcomes
  • pancreas transplantation

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