First World Consensus Conference on pancreas transplantation: Part II – recommendations

Ugo Boggi(University of Pisa), Fabio Vistoli(University of Pisa), Axel Andrès(University of Geneva), Helmut Arbogast(Ludwig-Maximilians-Universität München), Lionel Badet(Université Claude Bernard Lyon 1), Walter Baronti(University of Pisa), Stephen T. Bartlett(University of Maryland, Baltimore), Enrico Benedetti(University of Illinois Chicago), Julien Branchereau(Centre Hospitalier Universitaire de Nantes), George W. Burke(University of Miami), Fanny Buron(Université Claude Bernard Lyon 1), Rossana Caldara(San Raffaele University of Rome), Massimo Cardillo(Istituto Superiore di Sanità), Daniel Casanova(Universidad de Cantabria), Federica Cipriani(Vita-Salute San Raffaele University), Matthew Cooper(MedStar Heart & Vascular Institute), Adamasco Cupisti(University of Pisa), José Davide(Universidade do Porto), Cinthia B. Drachenberg(University of Maryland, Baltimore), Eelco J.P. de Koning(Leiden University Medical Center), Giuseppe Maria Ettorre(Carlo Forlanini Hospital), Laureano Fernández Cruz(Hospital Clínic de Barcelona), Jonathan A. Fridell(Indiana University – Purdue University Indianapolis), Peter J. Friend(University of Oxford), Lucrezia Furian(University of Padua), Osama Gaber(Methodist Hospital), Angelika C. Gruessner(State University of New York), Rainer W.G. Gruessner(State University of New York), Jenny E. Gunton(Westmead Institute for Medical Research), Duck Jong Han(Asan Medical Center), Sara Iacopi(University of Pisa), Emanuele F. Kauffmann(University of Pisa), Dixon B. Kaufman(University of Wisconsin–Madison), Takashi Kenmochi(Fujita Health University), Hussein Khambalia(Manchester Royal Infirmary), Quirino Lai(Policlinico Umberto I), R.M. Langer(Krankenhaus der Elisabethinen), Paola Maffi(San Raffaele University of Rome), Lorella Marselli(University of Pisa), Francesco Menichetti(University of Pisa), Mario Miccoli(University of Pisa), Shruti Mittal(University of Oxford), Emmanuel Morélon(Université Claude Bernard Lyon 1), Niccolò Napoli(University of Pisa), Flavia Neri(University of Padua), José Oberholzer(University of Virginia), Jon S. Odorico(University of Wisconsin–Madison), Robert Öllinger(Charité - Universitätsmedizin Berlin), Gabriel C. Oniscu(Edinburgh Royal Infirmary), Giuseppe Orlando(Wake Forest University), Monica Ortenzi(Marche Polytechnic University), Marcelo Perosa(Hospital Leforte), Vittorio Perrone(University of Pisa), Henry Pleass(The University of Sydney), Robert R. Redfield(University of Wisconsin–Madison), Claudio Ricci(University of Bologna), Paolo Rigotti(University of Padua), R. Paul Robertson(University of Washington), Lainie Friedman Ross(University of Chicago Medical Center), Massimo Rossi(Policlinico Umberto I), F Saudek(Institute of Clinical and Experimental Medicine), Joseph R. Scalea(University of Maryland, Baltimore), Peter Schenker(Ruhr University Bochum), Antonio Secchi(San Raffaele University of Rome), Carlo Socci(San Raffaele University of Rome), Donzília Sousa Silva(Universidade do Porto), Jean Squifflet(University of Liège), Peter G. Stock(University of California, San Francisco), Robert J. Stratta(Wake Forest University), Chiara Terrenzio(University of Pisa), Pablo Uva, Christopher J.E. Watson(University of Cambridge), Steven White(Freeman Hospital), Piero Marchetti(University of Pisa), Raja Kandaswamy(University of Minnesota), Thierry Berney(University of Geneva)
American Journal of Transplantation
July 10, 2021
10.1111/ajt.16750
Cited by 90Open Access
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Abstract

The First World Consensus Conference on Pancreas Transplantation provided 49 jury deliberations regarding the impact of pancreas transplantation on the treatment of diabetic patients, and 110 experts' recommendations for the practice of pancreas transplantation. The main message from this consensus conference is that both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplantation alone can improve long-term patient survival, and all types of pancreas transplantation dramatically improve the quality of life of recipients. Pancreas transplantation may also improve the course of chronic complications of diabetes, depending on their severity. Therefore, the advantages of pancreas transplantation appear to clearly surpass potential disadvantages. Pancreas after kidney transplantation increases the risk of mortality only in the early period after transplantation, but is associated with improved life expectancy thereafter. Additionally, preemptive SPK, when compared to SPK performed in patients undergoing dialysis, appears to be associated with improved outcomes. Time on dialysis has negative prognostic implications in SPK recipients. Increased long-term survival, improvement in the course of diabetic complications, and amelioration of quality of life justify preferential allocation of kidney grafts to SPK recipients. Audience discussions and live voting are available online at the following URL address: http://mediaeventi.unipi.it/category/1st-world-consensus-conference-of-pancreas-transplantation/246.

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