Pancreas transplantation: an overview

Area of Science:

• Nephrology
• Transplantation Medicine
• Endocrinology

Background:

• Pancreas transplantation is the sole curative treatment for insulin-dependent diabetes, restoring normal glucose and HbA1c levels.
• Significant advancements in surgical techniques, organ preservation, and immunosuppression have driven progress in pancreas transplantation.
• Graft loss is primarily attributed to technical failures and immunological complications like rejection.

Purpose of the Study:

• To review the evolution, outcomes, and complications of pancreas transplantation.
• To highlight the effectiveness of pancreas transplantation in managing type 1 diabetes.
• To discuss future directions, including islet transplantation.

Main Methods:

• Review of literature on pancreas transplantation outcomes and complications.
• Analysis of graft loss causes, including technical failures and rejection.
• Examination of patient survival rates and quality of life improvements.

Main Results:

• Technical failure (e.g., thrombosis, pancreatitis, infection) is the leading cause of early graft loss.
• Immunological complications, particularly rejection, affect 30% of patients, causing graft loss in 10%.
• Cardiovascular diseases are the primary cause of late mortality, despite improved quality of life and survival.

Conclusions:

• Pancreas transplantation remains the most effective treatment for type 1 diabetes, significantly improving patient survival and quality of life.
• Addressing technical failures and immunological rejection is crucial for long-term graft success.
• Islet transplantation offers a promising alternative to minimize surgical risks and immunosuppression.