Supplementary Table 3.

Recipient eligibility criteria for solid pancreas transplantation by current national pancreas protocols.

	Recipient age and BMI	Other recipient-related criteria	Contraindications
Australia and New Zealand [13]	<50 years old* (solid pancreas recipient) >18 years old (islet recipient) <35 kg/m2 (solid pancreas recipient) Ideally <80kg (islet recipient)	Solid pancreas recipient: T1DM+GFR <30ml/min (for SPK) Patient iliac vessels bilaterally Absence of significant cardiac disease (or adequately treated cardiac disease) C-peptide testing is suggested	Solid pancreas recipient: Significant cardiac or vascular disease Continuous dual antiplatelet therapy that cannot be safely ceased Significant psychiatric disease affecting ability to comply with treatment Ongoing cigarette smoking Addiction to non-prescription illicit drugs Inability to comply with complex medical therapy
USA [11]	No formal recipient age limits Accrues waiting time once ≥18 years old and all of: Registered for an SPK Qualifies for kidney waiting time Is on insulin	SPK recipient needs one of: Diagnosis of diabetes Evidence of pancreatic exocrine insufficiency Require procurement or transplantation of pancreas as part of a multiple organ transplant	None listed
UK [12]	No formal recipient age limits ≤30 kg/m2 (solid pancreas recipient) ≥31 kg/m2 (initial offer to islet recipient)	All: insulin-treated diabetes (mainly Type 1 diabetes but a minority of Type 2 diabetic patients are suitable) SPK recipient: Receiving dialysis OR GFR ≤20 ml/min PTA recipient: ≥2 severe hypoglycaemic episodes within last 24 months AND assessed by an endocrinologist to have disabling hypoglycaemia C-peptide and autoantibody testing is suggested	Absolute contraindications: Excessive cardiovascular risk (severe and non-correctable coronary artery disease OR myocardial infarction within 6 months) Non-curable malignancy Active sepsis Active peptic ulcer Major psychiatric history affecting adherence to treatment Inability to withstand surgery and immunosuppression Relative contraindications: Ejection fraction <50% Cerebrovascular accident+long-term impairment Active Hepatitis B or C BMI >30 kg/m2 (absolute for PTA or T2DM recipients) Extensive peripheral vascular disease Continued abuse of alcohol or drugs Insulin requirements >100 units/day
Eurotransplant [9]	No formal recipient age limits listed	Autoantibody (IA-2, ICA-, GAD) positive If autoantibody-negative: C-peptide ≤0.5 ng/ml+no increase >20% after stimulation	None listed

BMI – body mass index; GAD – glutamic acid decarboxylase; GFR – glomerular filtration rate; IA – insulin autoantibody; ICA – islet cell antibody; PAK – pancreas after kidney transplantation; PTA – pancreas transplantation alone; SPK – simultaneous pancreas-kidney transplantation; T2DM – type 2 diabetes mellitus.