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Pancreas transplantation: indications and consequences
1Section of Diabetes, Endocrinology, and Metabolism, Department of Internal Medicine, 983020 Nebraska Medical Center, Omaha, Nebraska 69198-3020, USA. jlarsen@unmc.edu
Endocrine Reviews
|December 8, 2004
Summary
Pancreas transplantation offers improved outcomes for diabetes mellitus management. This review details transplant procedures, risks, benefits, and the crucial role of endocrinologists in post-transplant care for optimal patient survival.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation Medicine
Background:
- Pancreas transplantation is an evolving strategy for managing diabetes mellitus.
- It encompasses various procedures with distinct indications, risks, and outcomes.
- The first combined pancreas-kidney transplant occurred in 1967.
Purpose of the Study:
- To review pancreas transplant procedures, comparing them to kidney transplantation alone.
- To analyze the impact of pancreas transplant on diabetes complications (hyperglycemia, hypoglycemia, micro/macrovascular issues).
- To discuss risks associated with immunosuppression post-transplant.
Main Methods:
- This is a review article.
- It synthesizes information on pancreas transplant procedures, outcomes, and complications.
- Compares pancreas transplant outcomes with kidney transplantation alone.
Main Results:
- Pancreas transplant affects diabetes complications like hyperglycemia and hypoglycemia.
- Immunosuppression introduces risks such as infections, cancer, and osteoporosis.
- Impacts on blood pressure, lipids, and glucose tolerance due to medications are reviewed.
Conclusions:
- Endocrinologist involvement is vital for pancreas transplant recipients, even with normal glucose.
- Management includes diabetic complications, bone loss prevention, and graft failure screening.
- Multidisciplinary teams are essential for maximizing long-term quality of life and survival.