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[Pancreas transplantation--a review].
1Kirurgisk avdeling Rikshospitalet, Oslo.
Summary
Pancreas transplantation is a viable treatment for type 1 diabetes with end-stage renal disease, especially when combined with a kidney transplant. Advances in immunosuppression have improved solitary pancreas graft survival, increasing enthusiasm for this procedure.
Area of Science:
- Nephrology
- Transplantation Immunology
- Endocrinology
Context:
- Pancreas transplantation is a treatment option for type 1 diabetic patients with end-stage renal disease.
- Simultaneous pancreas-kidney transplantation demonstrates equivalent graft survival rates for both organs.
- Solitary pancreas transplantation outcomes have historically been less favorable due to rejection challenges.
Purpose:
- To provide an overview of pancreas transplantation, including surgical techniques and outcomes.
- To review the experience with 122 pancreas transplantations performed at the National Hospital, Oslo.
- To discuss the impact of new immunosuppressive drugs on graft survival.
Summary:
- The International Pancreas Transplant Registry reports over 1,000 annual pancreas transplants.
- Simultaneous pancreas-kidney transplants offer good graft survival for diabetic patients with renal failure.
- Solitary pancreas transplant outcomes have improved with novel immunosuppressive agents, though challenges remain.
Impact:
- Improved quality of life for recipients with functioning pancreas grafts.
- Long-term effects on diabetes complications require further documentation.
- The shift from bladder to enteric drainage improved management of exocrine pancreas drainage complications.