[Transplantation of the pancreas]

Diabetes mellitus is a chronic disease with increasing prevalence in the population of the whole word. Transplantation of pancreas represents pro tempore the only treatment of Type I diabetes, which can assure long-lasting normal glycaemia and the independence from the insulin administration. However, transplantation still has higher morbidity and requires permanent immunosuppression. Authors describe their clinical experience with more than 200 transplantation of pancreas and they compare them with literary data. They review the basic problems and indications to the transplantation and in details describe the technique of the operation. Attention is given to the possible complications and to the immunological side of treatment. As a standard, the surgical technique has been using combined transplantation of pancreas and kidney. The most widely used method is the transplantation of the whole gland with a duodenal segment, which enables drainage of pancreatic juices into the intestine of the recipient. Due to the introduction of new immunosuppressives, it is possible to improve the long-term results of transplantations. Early diagnostics of the rejection of the pancreatic graft remains a specific problem.