PERSPECTIVE article
Front. Transplant.
Sec. Abdominal Transplantation
Importing Pancreata for Transplantation: A Single-Center Experience Across Evolving Allocation Eras
Provisionally accepted
Riccardo Tamburrini1,2*
Stacey Hidalgo1,3
Glen Leverson1
Dixon B Kaufman1,2,3Nikole A Neidlinger1,2,3
David P Al-Adra1,2,3David D Aufhauser1,2,3Carrie Thiessen1,2,3Didier Mandelbrot1,3
Sandesh Parajuli1,3
Jon S Odorico1,2,3*- 1University of Wisconsin-Madison, Madison, United States
- 2University of Wisconsin-Madison School of Medicine and Public Health, Madison, United States
- 3UWHealth Transplant Center, Madison, Wisconsin, United States
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Recent changes to allocation systems have increased the geographic distribution of pancreas offers, often originating from outside a transplant center's donor service area or region. The impact of this wider sharing on outcomes remains uncertain. This study analyzed outcomes of primary pancreas transplants (2000–2018) at a large transplant center, stratified retrospectively on the nautical miles distance from the donor hospital. Primary endpoints were death-censored graft survival (DC-GS), patient survival, and graft thrombosis at different time points. No significant differences were found in DC-GS or patient survival for recipients of simultaneous pancreas-kidney (SPK), pancreas after kidney (PAK), or pancreas transplant alone (PTA), regardless of the distance from the donor hospital to the transplant center. Thrombosis rates were comparable across groups. Imported pancreata were from younger donors with lower BMI compared to locally recovered grafts. These findings support the notion that importing pancreata for transplantation is a feasible and safe practice that benefits patients, increases organ utilization, while benefiting transplant center volume data and reducing waiting times for patients. Encouraging wider importation may reduce waiting times and improve access to pancreas transplantation.
Keywords: Pancreas Transplantation, organ allocation, Procurement Distance, Cold ischemia time, Graft Survival
Received: 03 Sep 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Tamburrini, Hidalgo, Leverson, Kaufman, Neidlinger, Al-Adra, Aufhauser, Thiessen, Mandelbrot, Parajuli and Odorico. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Riccardo Tamburrini
Jon S Odorico
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