325.10 A Study of Effectiveness of Preceding Solo-Kidney Transplantation for Type1 Diabetes with End Stage Renal Failure Taihei Ito, Takashi Kenmochi, Kei Kurihara, Naohiro Aida Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Aichi, Japan. Background: Patients with type 1 diabetes associated with end stage renal failure are indicated for simultaneous pancreas and kidney transplantation (SPK), but if the living donor is available, can transplant surgeons recommend that preceding solo-kidney transplantation prior to pancreatic transplantation be carried out? Methods: To study of effectiveness of preceding solo-kidney transplantation for type1 Diabetes with end stage renal failure, comparative retrospective analysis was performed between SPK (n=232) and pancreas transplantation after kidney (PAK) (n=39) which have been performed until December 2016. Results: 1. Is the waiting period prolonged for pancreas transplantation if kidney transplantation is preceded? We compared the waiting periods of 232 cases of SPK and 39 cases of PAK that were carried out in Japan until December 2016. The median waiting period was SPK: 1127 (11-4974) days and PAK: 710 (58-4453) days, showing no statistically significant difference (p=0.078) but having a shorter tendency in PAK. 2. After PAK, does renal function deteriorate? Among 35 cases of PAK who had undergone surgery one year prior, s-Cre values before surgery and one year after surgery were compared. It was found that s-Cre one year after surgery had statistically significantly increased (p=0.022). However, the median sCre had slightly increased from 1.18 mg/dl before surgery to 1.21 mg/dl one year after surgery, which is not considered clinically problematic. 3. Is pancreatic graft survival the same with SPK? 1, 3 and 5-year pancreatic graft survival after SPK was 87.5%, 86.4%, 82.8%, respectively, and 87.1%, 65.0%, 49.1% after PAK, indicating no differ- ence in 1-year survival. Upon examining the causes of pancreatic graft loss, graft loss occurred due to rejection among 8/37 cases (21.6%) after SPK; whereas after PAK it occurred for the same reason among 10/16 cases (62.5%), indicating significantly higher occurrence of pancreatic graft loss due to rejection (p=0.01). However, in PAK using rATG for induction, rejection occurred as a complication among 2/15 cases (12.3%), indicating a lower ten- dency compared to that occurring among cases in which rATG was not used (10/24 cases, 41.7%). Moreover, while 5-year pancreatic graft survival was 37.6% after PAK not using rATG, it was revealed that survival of 78.8% could be maintained in cases of rATG induction. 4. Can the prognosis be improved by a preceding kidney transplantation? The life prognosis of patients waiting for SPK and PAK was compared.1, 3, and 5-year survival of patients waiting for SPK was 98.4%, 92.1%, and 88.0%, respectively, while that of patients waiting for PAK was 100%, 96.6%, and 96.6%, with the life prognosis of patients waiting for PAK signifi- cantly better than those waiting for SPK (p=0.029). Conclusion: According to considering patient survival, preceding solo- kidney transplantation for type1 Diabetes with end stage renal failure should be performed if donor is available. 325.11 Decline in Pancreas Transplantation Numbers is Accompanied with Lower Publication Rates Stan Benjamens 1,2 , Christian Margreiter 3 , Eelco J.P. de Koning 4 , Henri G.D. Leuvenink 1 , Robert A. Pol 1 1 Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, Groningen, Netherlands; 2 Medical Imaging Center, University Medical Center Groningen, Groningen, Netherlands; 3 Department of Visceral, Transplant, and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria; 4 Department of Internal Medicine, Division of Nephrology, Leiden University Medical Center, Leiden, Netherlands. Introduction: After several years of growth in many pancreas transplant pro- grams, the United Network for Organ Sharing (UNOS) database reports a de- cline in transplant numbers in the USA. This trend urges for an evaluation of the transplant numbers and scientific productivity in the Eurotransplant (ET) region and the UK. Materials and Methods: We used the UNOS database, ETregistry, and the UK transplant registry to describe the development of pancreas transplanta- tion rates between 1997 and 2016. Next, we used the Web of Science data- base for a bibliometric analysis of scientific publications in the field of pancreas transplantation. Transplantation rates were adjusted for changes in population size in the different regions. We calculated graph specific slopes and annual average changes to assess trends in pancreas transplantation and scientific publications rates. Results and Discussion: For the USA and the ETregion, from 2004 the trend in transplant numbers changes from growth to decline, with highest an- nual transplant numbers of 5.1 per million inhabitants in the USA and of 2.4 per million in the ETregion. Between 2004 and 2016 the average annual de- cline rate per million inhabitants was 3.3% for the USA and 2.5% for the ET region. In the UK, yearly transplant numbers show a growth until 2009, with 3.6 transplants per million inhabitants, after which the numbers showed an av- erage annual decline of 1.0%. Following this trend, publications in Q1 journals showed an annual average change of +0.1%, -2.1% and +20.1%, before 2004, and a change of -4.1%, -3.8% and -5.45%, between 2004 and 2016, for respectively worldwide, the USA and the ET publications (Figure 2). From the 10 publications with the highest impact in this field, 9 publications were from USA-based authors and 5 out of 10 used data from the UNOS database, none were based on European studies. FIGURE 1. S78 Transplantation ■ July 2018 ■ Volume 102 ■ Number 7S www.transplantjournal.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.