[Pancreatic transplantation: technics--results]

Renewed interest is occurring in organ transplantation due to improvement of results. Pancreatic transplantation, carried out in more than 60 centers worldwide, has evolved since the first transplant in Minneapolis in 1966. Until 1978 an average of 6 operations per year were performed with a 1-year graft survival of 3%. The initial technic used was mainly duodenopancreatic transplantation with digestive by pass of external pancreatic secretions. Serious surgical complications led to progressive abandon of this procedure. Segmental transplantation, particularly after the appearance of methods of obliteration of wirsung's duct in 1978, has simplified the surgical act and stimulated renewed interest in pancreatic transplantation. The improvement in the technic, selection of donors and recipients and protocols of immunosuppression can hopefully allow a 1-year survival of graft of 55%. The current tendency is also to restore use of duodenopancreatic or total pancreatic transplants with intestinal or bladder drainage of secretions, providing improved survival of the graft in technically successful transplantations.