What is the survival rate for a pancreas transplant?

Pancreas Transplant Survival Rates

Pancreas transplant survival rates are excellent and vary significantly by transplant type: simultaneous pancreas-kidney (SPK) transplants achieve approximately 85% 5-year graft survival, while pancreas transplant alone or pancreas after kidney transplant achieve 55-70% 5-year graft survival. 1

Patient Survival Rates

• 1-year patient survival exceeds 95-96% across all pancreas transplant categories, representing a substantial improvement over historical outcomes 1, 2, 3, 4
• 5-year patient survival exceeds 88%, demonstrating excellent long-term outcomes 3
• Operative mortality remains low at less than 1% when appropriate patient selection criteria are followed (age <50 years, BMI <30 kg/m², absence of coronary artery disease) 1

Graft Survival by Transplant Type

Simultaneous Pancreas-Kidney (SPK) Transplants

• 1-year pancreas graft survival: >85-90% 2, 3
• 5-year pancreas graft survival: >85% 1
• Insulin independence achieved in >80% of recipients 1
• Estimated graft half-life: 13-16.7 years, the longest among extrarenal grafts 2, 4
• SPK transplants confer superior long-term graft function compared to other pancreas transplant categories 1

Pancreas After Kidney (PAK) Transplants

• 1-year pancreas graft survival: >86% 2
• 5-year pancreas graft survival: 55-70% 1
• Insulin independence achieved in >70% of recipients 1
• Estimated graft half-life: almost 10 years 2

Pancreas Transplant Alone (PTA)

• 1-year pancreas graft survival: >86% 2
• 5-year pancreas graft survival: 55-70% 1
• Estimated graft half-life: >6 years 2

Factors Contributing to Improved Outcomes

The dramatic improvements in survival rates over recent decades are attributable to several key advances:

• Significant reductions in technical failures through standardization of surgical techniques 2
• Decreased immunologic graft losses due to superior immunosuppressive protocols 2
• Better patient and donor selection criteria that minimize operative risk 1, 2
• Modern immunosuppression regimens have reduced 1-year immunologic graft loss rates to 2% after SPK, 9% after PAK, and 16% after PTA 5

Important Caveats and Complications

• Reoperation rates can reach 40% due to removal of technically failed grafts and routine complications of abdominal surgery 1
• Early technical pancreas graft loss occurs in approximately 10% of cases despite optimal patient selection 1
• Rejection accounts for 32% of graft failures in the first year after transplantation 6, 5
• Infections are more common in kidney-pancreas transplant recipients compared to kidney transplantation alone 1
• SPK transplantation is associated with higher rates of acute renal allograft rejection compared to kidney transplant alone, though newer immunosuppressive regimens have significantly decreased these rates 1

Long-Term Functional Outcomes

• Most SPK recipients can expect amelioration of problematic hypoglycemia for more than a decade 1
• Successful pancreas transplantation eliminates the need for exogenous insulin and significantly improves quality of life 1
• Even with partial graft function, protection from hypoglycemia is maintained in insulin-requiring recipients 1