If our Transplant Institute staff determines that you are a transplant candidate, we will add your medical profile to the national patient list for organ transplant that is maintained by the United Network for Organ Sharing (UNOS) in Richmond, Virginia. You will join a list of people waiting for a pancreas donation from a deceased donor.
Our Transplant Institute tracks wait times each year by blood type. We measure transplant volume by organ type, waiting time for a transplant, one-year survival rate by organ type, and quality of life before and after the transplant.
The Scientific Registry of Transplant Recipients (SRTR) also publishes center-specific reports with a wide range of useful information about transplant programs operating in the United States. The information includes many features of the BIDMC transplant program, such as the number of transplants performed in recent years, waiting time and waitlist outcomes, and the post-transplant experience of our patients. The statistics allow comparisons to national averages, as well as to the experience for similar patients at other centers in the country. The waitlist report is based on BIDMC data for patients transplanted within the last five years.
The majority of deceased donor organs for BIDMC transplant patients come from donors in New England. The transplant is coordinated by the New England Organ Bank (NEOB) , which operates according to policies set by the United Network for Organ Sharing (UNOS) , as supervised by the federal government. When a donor is identified, the NEOB sends UNOS information about the donor, including blood type, vital statistics such as blood pressure and weight, donor age and cause of death, information about blood tests, blood test results and social history.
Simultaneous Pancreas and Kidney Transplant
Some patients may be candidates for a simultaneous pancreas and kidney transplant. Sometimes the two organs can be transplanted at the same time, from the same deceased donor. Most often, a kidney becomes available from a living donor first, followed by a pancreas transplant from a deceased donor.
For a host of medical, scientific and emotional reasons, a living donor may be your best option for the kidney transplant. If this is not an immediate possibility for you, then we add your medical profile to the national patient list for organ transplant. You will join a list of people waiting for a combined kidney and a pancreas donation from a deceased donor.
Standard Criteria Donors
Pancreas donors are usually less than 45 years of age and have a Body Mass Index (BMI) of less than 30.
A standard criteria donor pancreas comes from a deceased donor who is declared brain dead. Brain death is defined when someone is maintained on life support - including a respirator that breathes for him or her - and has a beating heart. This can happen after a severe traumatic brain injury, stroke or other injury to the brain. Brain death means that there is the irreversible loss of function of the brain. A diagnosis of brain death can be made on a careful neurological examination or by demonstrating loss of blood flow to the brain. A flatline EEG can also be used to confirm brain death (an EEG, or electroencephalogram, records and measures the brain's electrical activity). Once brain death has been declared, the donor is legally dead.
Donation after Cardiac Death
A donor pancreas can also come from a non-heart-beating donor, also known as Donation after Cardiac Death (DCD). These are donors with severe brain injury with no hope for meaningful recovery and who do not meet the criteria for brain death. The family in consultation with the patient's physician may decide to withdraw life support. After the patient's heart stops and he or she is declared dead, the patient is taken to the operating room and the organs are removed.
Extended Criteria Donors for SPK
If you are having a simultaneous pancreas and kidney transplant (SPK), we may ask you to consider a pancreas from a non-heart-beating donor (donation after cardiac death). And if a living donor kidney is not an option for you, we may ask you to consider a kidney from an extended criteria donor (ECD). These kidneys have certain risk factors. You can read more about ECD kidneys on our web site or ask your transplant team to explain the options to you.
The Transplant Institute at Beth Israel Deaconess Medical Center is one of the nation's leaders in using extended criteria donor kidneys, including donors after cardiac death, with excellent outcomes. Our team is available 24 hours a day, seven days a week, 365 days a year to perform the transplantation surgery to ensure the best opportunity for a successful transplant outcome. Our program emphasizes short preservation times to maximize organ function.
For More Information
The transplant staff will explain the different types of deceased donors to you during your pre-transplant clinic visits. You will decide which option you wish to pursue by signing a consent form. Ask your transplant team for more information if you have any questions about the different types of deceased donors and the allocation process.