1. General Organ Donor Criteria
2. No known diabetes mellitus or insulin dependence
3. No known pancreatic trauma - may be considered for separated islets
4. No history of alcoholism or chronic pancreatitis
1. Blood group
2. Body weight
3. Approximate height
4. Laboratory tests: - General Organ Donor Criteria for viral studies
The unit accepting the pancreas offer is responsible for arranging the surgical procedure using a team of qualified surgeon(s) and associated staff. The unit accepting the pancreas offer is responsible for liaison with the relevant donor co-ordinator to achieve surgical starting times mutually acceptable to the donor hospital and all donor surgical teams involved. The unit accepting the pancreas offer is responsible for ensuring that the pancreas meets medical standards for organ donation and is delivered in a safe and appropriate manner to the recipient unit's hospital.
Whole pancreas/kidney or pancreas transplantation take precedence over separated islet transplantation. The Pancreas Transplant Unit in the State of the donor's hospital is offered the donation first (NSW/ACT-NSW, VIC/TAS – VIC). If the State unit does not want to accept the offer, it will be offered to the other Pancreas Transplant centre (NSW/ACT to VIC, or VIC/TAS to NSW) subject to state based kidney allocation rules for Pancreas/Kidney transplants. Retrieval of the pancreas from states without a pancreas transplant program (SA, NT, QLD, WA,) should be offered to the NSW pancreas transplant program, since the patients from those states are on the NSW unit’s waiting list.
Following refusal for solid pancreas transplantation, the islet allocation protocol operates.
Pancreas donations in NZ that cannot be used in NZ may be offered to the Australian National Pancreas-alone waiting list patients through contact with the NSW Pancreas Unit Transplant Coordinator.
New Zealand pancreas/kidney and pancreas-alone transplant recipients are transplanted in Auckland, New Zealand and allocated through the local waiting list.
1. General Organ Donor Criteria
2. No known diabetes mellitus or insulin dependence
3. No known pancreatic trauma
4. No history of alcoholism or chronic pancreatitis
Note: Neither Donor obesity, nor acute use of insulin in the ICU are contraindications for islet donation.
1. Blood group
2. Body weight
3. Approximate height
4. Laboratory tests: -
- General Organ Donor Criteria for viral studies
- electrolytes, glucose, amylase
- HIV, Hep BsAg, Hep C, CMV
- current use of Insulin, dextrose and steroids
The unit accepting the pancreas for islet isolation is responsible for arranging the surgical procedure using a team of qualified surgeon(s) and associated staff. The unit accepting the pancreas for islet isolation is responsible for liaison with the relevant donor co-ordinator to achieve surgical starting times mutually acceptable to the donor hospital and all involved donor surgical teams. The unit accepting the pancreas for islet isolation is responsible for ensuring that the pancreas meets medical standards for organ donation and is delivered in a safe and appropriate manner to the recipient unit's hospital.
Clinical islet transplantation takes precedence over research use of islets. Following refusal by the whole organ transplant units, a pancreas from any state should be offered for clinical islet isolation for the purpose of transplantation.
Currently there are no New Zealand pancreas offers are made for clinical or research islet transplantation, because of travel cost and the duration of cold ischaemia.
There is no such classification for pancreas or islet recipients.
ABO compatibility: absolute requirement
Lymphocytoxic crossmatch: peak and current serum negative test required
HLA matching: not required
Size and weight compatibility: not generally a consideration except at extremes
Waiting List: Patients are transplanted in order of presentation for assessment within each blood group, within each transplanting unit
The decision about each individual offer and waiting list management are the responsibility of each recognised pancreas transplant unit.
Note that acceptance for a simultaneous kidney/pancreas transplant usually over-rides the renal allocation mechanism and is determined by the State.
ABO compatibility: absolute requirement
Lymphocytoxic crossmatch: peak and current serum negative test required
HLA matching: not required
Size and weight compatibility: not generally a consideration except at extremes
Waiting List: Patients are transplanted in order of presentation to the national pancreas waiting list for within each blood group
Final acceptance of each individual offer and waiting list management are the responsibility of each recognised pancreas transplant unit.
ABO compatibility: absolute requirement
Lymphocytoxic crossmatch: peak and current serum negative test required
HLA matching: not required
Waiting List: Patients are transplanted from the national Islet transplant waiting list within each blood group
Patients will be entered onto the National Islet Waiting list by recognized Clinical Islet Transplant Programs.
Patients on the National Islet Waiting list will be associated to a recognized Clinical Islet Separation Laboratory, by the Clinical Islet Transplant Program
Each Clinical Islet Transplant Program for each Recipient Blood Group type may enter a maximum of two unsensitised and one sensitized patient (PRA >10%) onto the active list in any month. Each Transplant Program may thus hold a maximum of 12 active patients at any one time
Recipient Donor
A A
O O
B B or O
AB AB, B or A
– offers to NSW Islet Separation Laboratories for patients listed by Clinical Islet Transplant Programs in those states.
– offers to VIC Islet Separation Laboratories for patients listed by Clinical Islet Transplant Programs in those states.
Any patient in the blood group of the donor awaiting a second Islet transplant having received a first graft
(Note that a requirement for more than two islet transplants is not recognized for priority. Thus patients deemed by their program to require a third or any subsequent number of donations must be re-entered into the waiting list as requiring another first graft on each occasion)
The patient activated longest on the waiting list by blood group by donor state group.
The order of patients on the waiting list will be determined by activation date which will be the date of second tissue typing result report, or date of notification of activation by the Clinical Islet Transplant Program, whichever is the most recent. In other words patients may be tissue typed twice and be activated immediately or remain inactive at the discretion of the Clinical Islet Transplant Program, but when subsequently notified as activated, their date of activation is the date of a notification and not the date of tissue typing.
If an offer is refused by a patient or Clinical Islet Transplant Centre the offer moves to the next person on the waiting list in that Blood group. If all offers on a blood group list are refused then the offer can be made to an alternative compatible blood group list (an O donor refused by all O and B patients may then be offered to A and AB recipients)
(Definition of “a transplant unit” is that it is a clinical service of a State Public Hospital that actually performs the relevant transplant procedure)
Australian National Pancreas Transplant Unit Westmead (State approved Transplant program)
Australian National Pancreas Transplant Unit Monash (State approved Transplant program)
New Zealand National Pancreas Transplant Unit Auckland (State approved Transplant program)
(Definition of “a clinical islet separation facility” is that it is a clinical facility of a State Public Hospital that actually separates islets from human pancreata under an HREC approved protocol and with whatever regulatory approval/licencing is required)
NSW Westmead Islet Laboratory (HREC Approved protocol)
NSW Prince of Wales Islet Laboratory (HREC Approved protocol)
VIC St Vincent’s Islet Laboratory (HREC Approved protocol)
(Definition of “a transplant unit” is that it is a clinical service of a State Public Hospital that actually performs the relevant transplant procedure under HREC approved protocols)
NSW Westmead Hospital (HREC Approved protocol)
NSW Prince of Wales Hospital (HREC Approved protocol)
VIC St Vincent’s Hospital (HREC Approved protocol)
SA The Queen Elisabeth Hospital (HREC Approved protocol)
(Definition of “a research islet separation facility” is that it is a research facility of a State Public Hospital or Research Institute that actually separates islets from human pancreata for research under an HREC approved protocol and with whatever regulatory approval/licencing is required)
NSW Westmead Islet Laboratory HREC Approved protocol
NSW Prince of Wales Islet Laboratory HREC Approved protocol
SA The Queen Elisabeth Hospital/IMVS HREC Approved protocol
VIC St Vincent’s Islet Laboratory HREC Approved protocol