Pancreas transplantation following donation after circulatory death

Abstract

Diabetes mellitus is a major cause of morbidity and mortality worldwide. Pancreas transplantation has evolved into a viable treatment option in this patient population. While the majority of procedures are performed as either simultaneous pancreas-kidney (SPK) or pancreas after kidney (PAK), the resulting glycemic control leads to a significant delay in the progression of cardiovascular disease. At present, there is a critical organ shortage. Donation after circulatory death (DCD) may be a strategy to increase the pancreas donor pool. Herein, we examine the clinical parameters that impact organ selection and review the current experience with pancreas transplantation in the setting of DCD donation.