TY - JOUR
T1 - Impact of the revision of the law on pancreatic transplants in Japan—An analysis of the Japanese Pancreas Transplants Registry
AU - Ito, Taihei
AU - Kenmochi, Takashi
AU - Aida, Naohiro
AU - Kurihara, Kei
AU - Tomimaru, Yoshito
AU - Ito, Toshinori
N1 - Publisher Copyright:
© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery
PY - 2021/4
Y1 - 2021/4
N2 - Background: In Japan, it has been about 10 years since the revision of the law on donating brain-dead organs. The present study compared the outcomes of pancreatic transplant before and after the revision of the law. Methods: The 437 patients who had received pancreas transplantation were divided into two groups according to the time when pancreas transplantation was performed between era 1 (before the revision) and 2 (after the revision), and compared in the patient and pancreas graft survival. Results: While the annual number of brain-dead donors was <10 in era 1, and this number significantly increased in era 2 to >50. This resulted in an increased number of pancreas transplantations: >30 cases per year. The comparison data after a propensity score-matched analysis revealed that the death-censored pancreatic graft survival at 1, 3, and 5 years after pancreas transplantation in era 2 was 94.9%, 92.0%, and 92.0%, which, while lacking significance, tended to be better than the values of 90.5%, 83.1%, and 78.2%, respectively, in era 1. Conclusions: The revision of the law on donating brain-dead organs increased the number of pancreas transplantations. Technical improvements in surgery due to increased experience with performing pancreas transplants may help improve pancreatic graft survival.
AB - Background: In Japan, it has been about 10 years since the revision of the law on donating brain-dead organs. The present study compared the outcomes of pancreatic transplant before and after the revision of the law. Methods: The 437 patients who had received pancreas transplantation were divided into two groups according to the time when pancreas transplantation was performed between era 1 (before the revision) and 2 (after the revision), and compared in the patient and pancreas graft survival. Results: While the annual number of brain-dead donors was <10 in era 1, and this number significantly increased in era 2 to >50. This resulted in an increased number of pancreas transplantations: >30 cases per year. The comparison data after a propensity score-matched analysis revealed that the death-censored pancreatic graft survival at 1, 3, and 5 years after pancreas transplantation in era 2 was 94.9%, 92.0%, and 92.0%, which, while lacking significance, tended to be better than the values of 90.5%, 83.1%, and 78.2%, respectively, in era 1. Conclusions: The revision of the law on donating brain-dead organs increased the number of pancreas transplantations. Technical improvements in surgery due to increased experience with performing pancreas transplants may help improve pancreatic graft survival.
KW - brain-dead donors
KW - end-stage renal failure
KW - pancreas transplantation
KW - revision of the law
KW - type 1 diabetes
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U2 - 10.1002/jhbp.911
DO - 10.1002/jhbp.911
M3 - Article
C2 - 33554417
AN - SCOPUS:85101607222
SN - 1868-6974
VL - 28
SP - 353
EP - 364
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 4
ER -