Pancreas transplantation: the University of Wisconsin experience

The data presented in this chapter demonstrate that acceptable short-term results can now be achieved for patients receiving a pancreas transplant. We feel that urinary drainage and the use of a whole pancreas with a duodenal segment currently represent the most optimal technical approach. Immunosuppressive therapy using the quadruple induction protocol will prevent early rejection episodes in the majority of patients. Once rejection is diagnosed, one should not hesitate to institute immediate antirejection treatment with OKT3 monoclonal antibody. In our most recent series of 24 combined kidney and pancreas transplants an extremely encouraging outcome can be reported. Of the 24 patients who received a combined cadaver kidney and pancreatic allograft within the last 2 years, 23 are alive and well. Twenty-three also have good-functioning kidneys, of which 21 have a functioning kidney and pancreatic allograft. Based on these results, which will undoubtedly be duplicated in the very near future by a number of other centers, we believe that pancreas transplantation has now emerged into a therapeutic and effective procedure.