Abstract
A total of 437 cases of pancreas transplantation from deceased and living-related donors have been performed in 18 institutions in Japan between April, 2000, and the end of 2019. The following donor- and recipient-related factors were analyzed: age and gender of donor and recipient, cause of death, history of diabetes and hemodialysis, waiting period, total cold ischemic time, operative procedure, immunosuppression and survival rates of patient and graft. Based on the analyses, the current status of pancreas transplantation in Japan was demonstrated. Although the donor conditions have improved every year, they were still mostly marginal. The patient survival after the transplantation was 95.8%, 95.8% and 94.2% at 1, 3, and 5 years, respectively. The pancreas graft survival in SPK cases was 87.3%, 85.4%, and 83.2% at 1, 3, and 5 years, respectively. The pancreas graft survival in PAK (85.4%, 67.6%, and 52.3% at 1, 3, and 5 years, respectively) and PTA cases (66.7%, 41.6%, and 31.2% at 1, 3, and 5 years, respectively) was significantly poorer than in SPK. The main cause of pancreas graft loss was graft thrombus in SPK cases, while it was chronic rejection in PAK and PTA cases. In conclusion, we demonstrated the current status of pancreas transplantation in Japan. While the posttransplant outcome was comparable to that in the United States and Europe, it is necessary to overcome graft thrombus in SPK cases and chronic rejection in PAK and PTA cases for improving the posttransplant outcomes.
