Abstract
A total of 555 cases of pancreas transplantation from deceased and living-related donors have been performed in 21 institutions in Japan between April 2000 and the end of 2023. The following donor- and recipient-related factors were analyzed in the 528 cases from deceased donors out of the total 555 cases: 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 posttransplant survival rates of patient and graft. Based on the analyses, the current status of pancreas transplantation in Japan was described. The patient survival after the transplantation was 95.9%, 94.3% and 92.2% at 1, 3, and 5 years, respectively. The pancreas graft survival in cases with simultaneous pancreas and kidney transplantation (SPK) was 87.6%, 84.5%, and 81.7% at 1, 3, and 5 years, respectively. The pancreas graft survival in cases with pancreas after kidney transplantation (PAK) (82.7%, 67.7%, and 57.7% at 1, 3, and 5 years, respectively) and pancreas transplantation alone (PTA) (68.8%, 34.4%, and 20.6% at 1, 3, and 5 years) was significantly poorer than SPK. 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 favorable, it is necessary to overcome graft thrombus in SPK cases and chronic rejection in PAK and PTA cases for improving the posttransplant outcomes.
