Pancreas transplantation: long-term results

Area of Science:

• Nephrology
• Endocrinology
• Transplantation Surgery

Background:

• Pancreatic transplantation aims to restore endogenous insulin production and normalize metabolism.
• Secondary complications of diabetes mellitus necessitate improved treatment strategies.

Purpose of the Study:

• To evaluate the long-term clinical and metabolic outcomes of simultaneous kidney and pancreas transplantation.
• To assess the impact of transplanted pancreatic mass on graft function and patient outcomes.

Main Methods:

• Retrospective analysis of 8 patients undergoing simultaneous kidney and pancreas transplantation.
• Inclusion of 10 patients from a comparative study of segmental vs. whole pancreas transplantation.
• Assessment of graft function, insulin independence, HbA1c, 24-hour metabolic profiles, and oral glucose tolerance tests (OGTT).

Main Results:

• All patients remained alive with functioning grafts.
• Seven out of eight patients achieved insulin independence.
• Normal HbA1c levels were maintained throughout the follow-up period (4-5 years).
• Near-normal blood glucose levels and good insulin release were observed at 4 years, with mild hyperglycemia at 5 years.
• Impaired glucose tolerance was noted in OGTT at 4 and 5 years post-transplantation.

Conclusions:

• Simultaneous kidney and pancreas transplantation is a viable option for achieving long-term insulin independence.
• While metabolic control is generally good, careful monitoring for glucose tolerance is warranted in the long term.
• Transplanted pancreatic mass may influence long-term graft function and metabolic outcomes.