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Generating Strategies for a National Comeback in Pancreas Transplantation: A Delphi Survey and U.S. Conference Report
Journal article   Open access   Peer reviewed

Generating Strategies for a National Comeback in Pancreas Transplantation: A Delphi Survey and U.S. Conference Report

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, …
American journal of transplantation, Vol.24(8), pp.1473-1485
08/2024
DOI: 10.1016/j.ajt.2024.03.010
PMCID: PMC12225779
PMID: 38499089
url
https://doi.org/10.1016/j.ajt.2024.03.010View
Published (Version of record) Open Access

Abstract

In the United States, potential transplant candidates with insulin-dependent diabetes mellitus are inconsistently offered pancreas transplantation, contributing to a dramatic decline in pancreas allograft utilization over the past two decades. The American Society of Transplantation (AST) organized a workshop to identify barriers inhibiting pancreas transplantation and to develop strategies for a national comeback. The two-day workshop focused on four main topics: (1) referral/candidate selection, (2) organ recovery/utilization, (3) program performance/patient outcomes, (4) enhanced education/research. Topics were explored through expert presentations, patient testimonials, breakout sessions, and strategic planning, including 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 pancreas transplantation 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 pancreas transplantation training, education, and research. Partnership between national societies, patient advocacy groups, and professionals will be essential to realizing this critical agenda.
Economics Education efficiency organ procurement outcomes pancreas transplantation

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