Purpose of review: The current era of organ shortage has necessitated expansion of the currently available organ donor pool, to increase the number of pancreases available for transplant. This review summarizes the cumulative efforts of various centers in making this possible.
Recent findings: Various centers are consistently reporting their experience with marginal donors; recent additions to the cohort have been increase in pancreases from donors after cardiac death (controlled and uncontrolled), update on long-term outcomes of live pancreas donors, as well as efforts at objectively assessing donor risk.
Summary: It has become important for the transplanting surgeon to make difficult decisions on organ suitability and appropriateness depending upon the recipient's status. Further more, limiting further damage to these vulnerable grafts is important in improving utilization as well as successful transplantation.