Pancreas Transplantation Inside Emilia-Romagna, Italy: Referral Pattern, Demand Forecasting, and Organ Availability

Abstract In Italy, referralof diabetic patients for pancreas transplantation(PT) is an unstructured process, resulting in a low rate of activity and late referrals, often when the patient has already undergone dialysis. In addition, the continuous improvement in pancreas transplantalone, offering the opportunity to reduce cardiovascular risk due to proteinuriaand reduced glomerular filtration rate (GFR), is rarely appreciated. We therefore analyzed (1) referralactivity to PT during the time frame 2001–2005 in Emilia-Romagna, Italy (four million inhabitants), by collecting ICD 9 CM codes (55.69 + 52.80; 52.86 and 52.80 alone) by residence of the patient; (2) demand for PT among a sample population of 1670 diabetes patients, whose charts were reviewed for the type of diabetes and presence of overt diabetic nephropathy(DN: proteinuria> 300 mg/24 h and/or GFR