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Pancreas transplantation. A new program.
J P Boudreaux1, W H Nealon, R C Carson
1Department of Surgery, University of Texas Medical Branch, Galveston.
The American Surgeon
|February 1, 1991
Summary
Pancreas transplantation can successfully make insulin-dependent diabetics insulin-independent. Combined pancreas and kidney transplants offer a treatment choice for Type 1 diabetics with kidney issues.
Area of Science:
- Transplantation Surgery
- Endocrinology
- Nephrology
Background:
- Type 1 diabetes mellitus (T1DM) is a chronic condition requiring lifelong insulin therapy.
- Pancreatic graft failure and complications can lead to significant morbidity.
- Combined pancreas-kidney transplantation is an option for T1DM patients with end-stage renal disease.
Purpose of the Study:
- To evaluate the outcomes of pancreas transplantation in insulin-dependent diabetics.
- To assess patient and graft survival rates after pancreatico-duodenal transplants.
- To determine the efficacy of combined pancreas-renal transplantation.
Main Methods:
- Retrospective analysis of 16 pancreatico-duodenal transplants in 15 T1DM patients (aged 25-46).
- 14 patients received combined cadaveric pancreas/renal transplants with bladder drainage.
- Monitoring of complications, rejection episodes, and graft survival.
Main Results:
- 87% patient and kidney graft survival; 81% pancreas graft survival (1-20 months).
- All patients achieved insulin independence and normoglycemia (mean HbA1c 4.0% post-transplant).
- Mean serum creatinine improved to 1.4 mg/dl.
Conclusions:
- Pancreas transplantation can be successful in carefully selected T1DM patients.
- Combined pancreatic/renal transplantation is a viable treatment for T1DM with impaired renal function.
- Minimizing preservation injury during donor procurement is crucial for pancreas graft success.