OPTN/SRTR 2024 Annual Data Report: Pancreas.

In 2024, the overall number of adult pancreas transplants in the United States decreased to 821, an 8.0% drop from the prior year, predominantly driven by a decline in simultaneous pancreas-kidney (SPK) transplants. However, adult waitlist additions increased in SPK to 1,661 in 2024 from 1,585 in 2023. Adult transplant rates have declined steadily since 2019 to a low of 30.1 transplants per 100 patient-years in 2024. The proportion of candidates with type 2 diabetes on the waiting list was stable at 25.7% in 2024. Waiting time for adult SPK transplants continued to be relatively short, with only 23.2% of candidates on the waiting list at the end of 2024 having been waiting 2 years or more. Pretransplant mortality on the waiting list decreased to 4.5% in 2024, from 6.2% in 2020. The overall pancreas donor counts (adult and pediatric) have dropped to 1,131 in 2024 from 1,346 in 2013. Less than 10% of the donors were aged 40 years or older. While head trauma as a cause of death in pancreas donors remained lower in 2024 than a decade ago, anoxia as a cause of death started to stagnate beginning in 2022. Of the pancreata recovered for transplant in 2024, 25.1% were not transplanted. Outcomes after pancreas transplant in adults remained strong with only 9.4% graft loss in the first year following SPK transplant in 2023. Long-term death-censored kidney graft failure in SPK was low at 1.9%, 8.5%, and 15.9% at 1, 5, and 10 years, respectively. Mortality at 10 years posttransplant has also improved to 27.5%, 13.1%, and 20.6% for pancreas-after-kidney transplant, pancreas transplant alone, and SPK transplant, respectively.