168 Pancreas transplant outcomes after allocation though the NHSBT pancreas fast-track scheme (FTS)

Abstract Background The fast-track pancreas scheme (FTS) was brought in to improve pancreas utilisation. It created a scheme for the allocation of pancreas grafts not yet allocated at the time retrieval commenced. There are no previous reports of pancreas allocation using such a scheme. This study compares the outcomes of pancreas grafts allocated via the FTS versus those allocated before retrieval. Methods Data were collected on 1,297 pancreas donors offered through the FTS between 1/12/2010-31/03/2023from the UK Transplant Registry. Donor and recipient characteristics were compared, and graft and patient survival analyses conducted using Kaplan Meier plots. Results Pancreases offered through the FTS were more likely to be from older, heavier, taller, male, and donation after circulatory death (DCD) donors, with all differences statistically significant (p<0.0001). Recipients of FTS grafts tended to be older (p=0.0074). 166 simultaneous pancreas and kidney transplants were performed from the organs offered. No significant differences were found in graft survival at 1 year (FTS 92.4%, no-FTS 87.6%, p=0.104), 3 years (FTS 83.6%, no-FTS 82.9%, p=0.460), and 5 years (FTS 80.9%, no-FTS 79.4%, p=0.417). Patient survival was comparable between groups at 1 year (FTS 98.3%, no-FTS 95.6%, p=0.185), 3 years (FTS 94.3%, no-FTS 91.5%, p=0.287), and 5 years (FTS 87.7%, no FTS 86.6%, p=0.519). Conclusion Graft and patient survival rates are similar between those receiving fast-tracked pancreases and those receiving pre-allocated pancreases. This study confirms that despite the perception FTS grafts may be more high risk, pancreas transplant outcomes are comparable with no impact on overall outcomes.