Pancreas transplantation: a University of Minnesota perspective

Because of various difficulties, transplantation is restricted to specific situations. Surgery is considered elective by many insurers, so costs are often borne by the patient. Surgical work-up includes a thorough evaluation of diabetes-related complications, tissue typing, psychological state, and social issues. Options of cadaver versus living related donors are explored. The surgical procedure is lengthy and the hospital stay long and intensive. Once a patient is ambulatory, education is begun to meet the extensive learning needs. After discharge, surgical follow-up focuses primarily on blood chemistries, medication doses, and surgical complications. Medical follow-up includes monitoring for infections and rejection as well as addressing long-term complications of diabetes. Studies of the effects of transplantation on diabetes complications are encouraging which, when coupled with improved surgical outcomes, may increase opportunities for transplant.