In conclusion, these data indicate the requirement for a new allocation system also in the ET area to be able to provide a sufficient number of organs for patients on the waiting list. We therefore suggest a new pancreas allocation system where donors with an age of 50-60 years or a BMI of 30-34 are allocated regionally within a cold ischemic time < 12 h. To prove the hypothesis that extended pancreas allograft donors can be used safely with equal outcome in recipients a prospective comparative multicenter feasibility-study is required.