Novel immunosuppression in pancreas transplantation and outcomes

Pancreas transplantation continues to evolve and mature offering diabetic patients longer lives with improved quality of life and reduced morbidity. A review of current literature was performed to assess important trends in the care and outcome of patients following pancreas transplantation with and without simultaneous renal transplant.

Overall results of pancreas transplantation have improved worldwide. Since 1988, 1-year survival pancreas graft survival rates have improved from 75 to 85% for simultaneous kidney-pancreas transplants, 55 to 78% for pancreas after kidney transplants, and 45 to 77% for pancreas transplant alone. Over 80% of pancreas transplant recipients now receive induction therapy. Use of antibody induction has enabled an increase in the use of steroid free maintenance protocols from 4 to 24% of recipients nationwide. Furthermore, a variety of single center protocols, which are both calcineurin inhibitor and corticosteroid free, have recently reported. Finally, there is a growing acceptance of the safety and efficacy of pancreases obtained from donors following cardiac death.

Pancreas transplantation continues to evolve. To maximize benefits to current and future recipients, creative approaches to improve long-term graft survival and increase the organ supply must be evaluated.