Present status of pancreas transplantation in Japan

Since October 1, 1999, a total of 17 pancreas transplantations have been performed in Japan, involving 15 brain-dead donors and 2 non-heart beating donors. The donor ages were relatively high with 67% (10/15) over age 40 and brain death was typically attributable to cerebrovascular accidents (70.6%; 12/17). The majority of donors could be defined as marginal (13/17; 76.5%). Because of these adverse donor characteristics, the gastroduodenal artery of the graft was usually reconstructed to increase blood supply to the pancreas head when liver procurement was undertaken. Also, intensive insulin therapy was used to rest graft islets in some centers during the acute phase of transplantation. Patient survival was 100% with a mean follow-up period of 21 months (range: 4-54 months). All recipients have remained insulin-free without any need for dialysis. One patient lost a pancreatic graft to venous thrombosis, but was successfully retransplanted 2 years later. All recipients have displayed good QOL after transplantation. Nine recipients made a complete return to their jobs, while 5 patients made a partial return to light jobs, such as housework or office work.