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I P T R / UNOS International Pancreas Transplant Registry

International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

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Page 1: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

International Pancreas Transplant Registry

Page 2: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Pancreas Transplants

pre 7819781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009

0

200

400

600

800

1000

1200

1400

1600

Pancreas Transplants 12/16/1966 – 12/31/2009

USA: n = 23,850

Non US n = 11,365

1/10

Page 3: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

US Pancreas Transplants

pre 78

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

0

200

400

600

800

1000

1200

1400

1600

USA Pancreas Transplants 12/16/1966 – 12/31/2010

USA: n = 25,031

1/11

Page 4: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

19881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010

020406080

100120140160

0

200

400

600

800

1000

1200

1400

1600# Cen-ters

# of Txs

Centers

Number of Tx Centers and Number of Txs

01/11

Transplants

USA Pancreas Transplants 1/1/1988 – 12/31/2010

Page 5: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Pancreas Transplant CategoriesUSA SPK, PAK and PTA Transplants 1/1/1988 – 12/31/2010

01/11

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

200

400

600

800

1000

1200

PTAPAKSPK

Nu

mb

er o

f T

ran

spla

nts

Page 6: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Pancreas RetransplantsUSA Pancreas Transplants 1/1/1988 – 12/31/2010

1/11

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

0

20

40

60

80

100

120

140

160

180

PAK

PTA

SPK

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/0920

10/

0

5

10

15

20

25

30

35

40%#

Page 7: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

PAK PTA SPK0

100

200

300

400

500

600

700

800

900

SPKPTAPAK

Primary Transplant Type

# o

f re

tra

ns

pla

nts

USA Primary Pancreas Transplants 1/1/1988 – 12/31/2010

Type of Primary and Retransplant

Page 8: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Recipient AgeUSA Primary Pancreas Transplants 1/1/1988 – 12/31/2010

PAKPTASPK

Page 9: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Duration of DiabetesUSA Primary DD Pancreas Transplants 1/1/1996 –12/31/2010

PAKPTASPK

Page 10: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Age at Tx by Diabetes TypeUSA Primary DD Pancreas Transplants 1/1/2006 –12/31/2010

Type 1Type 2

PAK PTA SPK

20

30

40

50

60

70

Re

cip

ien

t A

ge

[Y

rs]

Page 11: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Diabetes Type and DurationUSA Primary DD Pancreas Transplants 1/1/2000 –12/31/2008

Type 1Type 2

PAK PTA SPK0

10

20

30

40

50

60

Du

rati

on

of

Dia

be

tes

[Y

rs]

Page 12: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Recipient GenderUSA Primary DD Pancreas Transplants 1/1/1988 – 12/31/2010

1/11

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/0

10

20

30

40

50

60

70

PAK

PTA

SPK

% Male

Page 13: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Patients with Type 2 Diabetes USA Primary DD Pancreas Transplants 1/1/1994 – 12/31/2010

2/11

1994/95

1996/97

1998/99

2000/01

2002/03

2004/05

2006/07

2008/09

2010/

0123456789

10PAK

PTA

SPK

%

Page 14: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

AfricanAmerican RecipientsUSA Primary DD Pancreas Transplants 1/1/1994 – 12/31/2010

2/11

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/02468

101214161820

PAK

PTA

SPK

%

Page 15: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Duct Management TechniqueUSA DD Primary Pancreas Transplants 1/1/1988 –12/31/2010

2/11

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/0

20

40

60

80

100PAK

PTA

SPK

% ED drained

Page 16: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Portal Drainage in ED TxsUSA DD Primary Pancreas Transplants, 1/1/1988 – 12/31/2010

2/11

1996/97

1998/99

2000/01

2002/03

2004/05

2006/07

2008/09

2010/

0

10

20

30

40

50

60PAK

PTA

SPK

%

Page 17: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Use of a Roux-Loop in ED TxsUSA Primary DD Pancreas Transplants, 1/1/1996 – 12/31/2010

2/11

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/0

10

20

30

40

50

60 PAK

PTA

SPK

%

Page 18: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/0

10

20

30

40

50

60

70

PAKPTASPK

HLA A,B,DR MismatchingUSA Primary DD Pancreas Transplants 1/1/1988 – 12/31/2010

3/11

% of 5 or 6 HLA Mismatch

Page 19: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Anti-T-Cell InductionUSA DD Primary Pancreas Transplants 1/1/1988 – 12/31/2010

2/11

1988

/89

1990

/91

1992

/93

1994

/95

1996

/97

1998

/99

2000

/01

2002

/03

2004

/05

2006

/07

2008

/09

2010

/0

20

40

60

80

100

PAK

PTA

SPK

%

Page 20: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Class I PRA levels > 20%USA DD Primary Pancreas Transplants 7/1/2004 – 12/31/2010

2/11

2004

/05

2006

/07

2008

/09

2010

/0

4

8

12

16

PAK

PTA

SPK

%

Page 21: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Class II PRA levels > 20%USA DD Primary Pancreas Transplants 7/1/2004 – 12/31/2010

2/11

2004

/05

2006

/07

2008

/09

2010

/0

4

8

12

PAK

PTA

SPK

%

Page 22: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

SPK Induction Antibody TherapyUSA DD Primary Pancreas Transplants 1/1/2000 – 12/31/2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

80

90

No Abs

Depl Abs

NonDepl Abs

Both

Transplant Year

%

3/11

Page 23: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

PAK Induction Antibody TherapyUSA DD Primary Pancreas Transplants 1/1/2000 – 12/31/2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

80

No Abs

Depl Abs

NonDepl Abs

Both

Transplant Year

%

3/11

Page 24: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

PTA Induction Antibody TherapyUSA DD Primary Pancreas Transplants 1/1/2000 – 12/31/2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

80

90

100

No Abs

Depl Abs

NonDepl Abs

Both

Transplant Year

%

3/11

Page 25: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

PAK PTA SPK0

10

20

30

40

50

60

70

80

90%

Antibody TherapyUSA Primary DD Pancreas Transplants 1/1/2006 – 12/31/2010

No ABs

Depl. AB

NonDepl. AB

Both ABs

3/11

Page 26: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

Overall Initial Steroid AvoidanceUSA Primary DD Pancreas Transplants 1/1/2000 – 12/31/2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

80

SPK

PAK

PTA

Transplant Year

%

3/11

Page 27: International Pancreas Transplant Registry. Pancreas Transplants Pancreas Transplants 12/16/1966 – 12/31/2009 nUSA: n = 23,850 nNon USn = 11,365 1/10

IPTR /UNOS

PAK PTA SPK0

20

40

60

80

MMF

CsA/MMF

TAC/MMF

TAC

SRL based

%

Major Immunosuppressive ProtocolsUSA Primary DD Pancreas Transplants 1/1/2006 – 12/31/2010

3/11