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Pancreatic transplantation: the Cambridge experience
1Department of Surgery, University of Cambridge, Addenbrooke's Hospital, United Kingdom.
The Journal of Diabetic Complications
|July 1, 1988
Summary
Paratopic pancreas transplantation offers physiological hormone delivery, improving glucose control in diabetic patients with kidney failure. This method preserves the incretin effect, crucial for hormonal stimulation of the entero-insular axis.
Area of Science:
- Transplantation immunology
- Endocrinology
- Metabolic studies
Background:
- Conventional insulin therapy and heterotopic pancreas transplantation present limitations in physiological hormone delivery.
- Diabetic patients with renal failure often require complex management strategies.
Purpose of the Study:
- To evaluate the metabolic outcomes of paratopic pancreas transplantation compared to other methods.
- To investigate the impact of pancreatic graft denervation on the entero-insular axis.
Main Methods:
- Metabolic studies in insulin-dependent diabetic patients with renal failure receiving paratopic pancreas transplants.
- Assessment of glucose control, fasting glucose, HbA1c, and hyperinsulinemia.
- Investigation of the entero-insular axis and incretin effect post-denervation.
Main Results:
- Paratopic pancreas grafts provided physiological endocrine hormone delivery into the portal circulation.
- Patients achieved near-normal daily glucose control, with normal fasting glucose and HbA1c levels.
- The incretin effect was preserved, indicating significant hormonal stimulation of the entero-insular axis, even after denervation.
Conclusions:
- Paratopic pancreas transplantation ensures physiological hormone delivery, leading to improved glycemic control in diabetic patients with kidney failure.
- The entero-insular axis and incretin effect remain functional, highlighting the benefits of this transplantation approach.