Pancreas Transplant Training in U.S. Transplant Nephrology Fellowships: National Survey of Current Barriers and Potential Solutions

Limited training opportunities for transplant nephrologists have been identified as a potential contributing factor for declining pancreas transplant volumes. However, data describing pancreas transplant training within transplant nephrology fellowships are scarce. We conducted a survey of 66 accredited U.S. transplant nephrology fellowship programs between December 2024 and May 2025 to assess perceived barriers and strategies to enhance pancreas transplant training. A total of 48 (72%) responses were received. A significant number of programs (n = 21; 44%) reported that they did not graduate fellows to meet the Organ Procurement and Transplantation Network eligibility requirements to become primary pancreas transplant physicians. 14 (29%) programs either did not perform pancreas transplants or performed fewer than 5 annually. Low pancreas transplant volume was identified as the most significant barrier to training. The most frequently endorsed solutions included designing dedicated pancreas transplant rotations, even at institutions outside their own, and implementing a standardized training curriculum. Such interventions may help address current training gaps and strengthen the future pancreas transplant workforce.