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The advent of Machine Perfusion (MP) as a superior form of preservation and assessment for cold storage of both high-risk kidney's and the liver presents opportunities in the field of beta-cell replacement. It is yet unknown whether such techniques, when applied to the pancreas, can increase the pool of suitable donor organs as well as ameliorating the effects of ischemia incurred during the retrieval process. Recent experimental models of pancreatic MP appear promising. Applications of MP to the pancreas, needs refinement regarding perfusion protocols and organ viability assessment criteria. To address the "Role of pancreas machine perfusion to increase the donor pool for beta cell replacement," the European Society for Organ Transplantation (ESOT) assembled a dedicated working group comprising of experts to review literature pertaining to the role of MP as a method of improving donor pancreas quality as well as quantity available for transplant, and to develop guidelines founded on evidence-based reviews in experimental and clinical settings. These were subsequently refined during the Consensus Conference when this took place in Prague. [ABSTRACT FROM AUTHOR]

Summary: Utilization of pancreases for transplantation remains inferior to that of other organs. Herein, we analysed UK pancreas discards to identify the reasons for the low utilization rates. Data on all pancreases offered first for solid organ transplantation between 1st January 2005 and 31st December 2015 were extracted from the UK Transplant Registry. The number of organs discarded, reasons and the time point of discard were analysed. A centre specific comparison was also undertaken. 7367 pancreases were offered first for solid organ transplantation. 35% were donors after circulatory death (DCD). 3668 (49.7%) organs were not retrieved. Of the 3699 pancreases retrieved, 38% were initially accepted but subsequently discarded. 2145 (29%) grafts offered were transplanted as simultaneous pancreas‐kidney or solitary pancreas. 1177 (55%) were transplanted on the first offer whilst the remaining 968 were transplanted after a median of three offers. 52% DBD pancreases were accepted and transplanted on the first offer compared with 68% DCD grafts. There were significant differences in discard rates between centres (30–80% for DBD and 3–78% for DCD, P < 0.001). A significant number of solid pancreases are discarded. Better graft assessment at retrieval could minimize unnecessary organ travel and discards. Closer links with islet programmes may allow for better utilization of discarded grafts. [ABSTRACT FROM AUTHOR]

We examined quality of life (QoL) and other patient‐reported outcome measures (PROMs) in 95 simultaneous pancreas and kidney transplant (SPKT) recipients and 41 patients wait‐listed for SPKT recruited to the UK Access to Transplantation and Transplant Outcome Measures (ATTOM) programme. Wait‐listed patients transplanted within 12 months of recruitment (n = 22) were followed 12 months post‐transplant and compared with those still wait‐listed (n = 19) to examine pre‐ to post‐transplant changes. Qualitative interviews with ten SPKT recipients 12 months post‐transplant were analysed thematically. Cross‐sectional analyses showed several better 12‐month outcomes for SPKT recipients compared with those still wait‐listed, a trend to better health utilities but no difference in diabetes‐specific QoL or diabetes treatment satisfaction. Pre‐ to post‐transplant, SPKT recipients showed improved treatment satisfaction, well‐being, self‐reported health, generic QoL and less negative impact on renal‐specific QoL (ps < 0.05). Health utility values were better overall in transplant recipients and neither these nor diabetes‐specific QoL changed significantly in either group. Pre‐emptive transplant advantages seen in 12‐month cross‐sectional analyses disappeared when controlling for baseline values. Qualitative findings indicated diabetes complications, self‐imposed blood glucose monitoring and dietary restrictions continued to impact QoL negatively post‐transplant. Unrealistic expectations of SPKT caused some disappointment. Measuring condition‐specific PROMs over time will help in demonstrating the benefits and limitations of SPKT. [ABSTRACT FROM AUTHOR]