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[Pancreas transplant].

L Fernández-Cruz Pérez, A Sáenz Coromina, E Astudillo Pombo

    Revista Clinica Espanola
    |July 1, 1989
    PubMed
    Summary
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    Pancreas transplantation can prevent diabetic complications and free patients from insulin therapy. However, risks associated with immunosuppression limit its use to high-risk patients, despite improved outcomes with cyclosporine.

    Area of Science:

    • Transplantation immunology
    • Endocrinology
    • Nephrology

    Background:

    • Pancreas transplantation can normalize hydrocarbon metabolism, preventing diabetic complications.
    • It liberates patients from insulin dependence and dietary restrictions.
    • Immunosuppression carries inherent risks, historically limiting transplantation to high-risk patients.

    Purpose of the Study:

    • To evaluate the efficacy and safety of pancreas transplantation.
    • To identify patient selection criteria for pancreas transplantation.
    • To assess the impact of immunosuppression and surgical techniques on outcomes.

    Main Methods:

    • Review of outcomes in patients undergoing pancreas transplantation.
    • Analysis of patient selection criteria including uremia, retinopathy, and proteinuria.

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  • Evaluation of immunosuppressive therapy, specifically cyclosporine.
  • Comparison of different surgical techniques, focusing on whole organ transplantation with urinary diversion.

    • Main Results:

    • Cyclosporine has improved graft survival rates to 53% actuarial survival per year.
    • Whole organ transplantation with urinary diversion demonstrated superior results.
    • Monitoring urine amylase allows for early detection of graft rejection.

    Conclusions:

    • Pancreas transplantation is a viable option for preventing diabetic complications in select high-risk patients.
    • Improved outcomes with cyclosporine and specific surgical techniques enhance graft survival.
    • Early rejection detection is facilitated by monitoring urine amylase in whole organ transplants.