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The case for pancreas transplantation

D E Sutherland1

  • 1Department of Surgery, University of Minnesota, Minneapolis, USA.

Diabetes & Metabolism
|April 1, 1996
PubMed
Summary

Pancreas transplants offer insulin independence for many diabetic patients. Routine pancreas transplantation is recommended for kidney transplant recipients and those with severe diabetes complications.

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Area of Science:

  • Transplantation immunology
  • Endocrinology
  • Nephrology

Background:

  • Over 6,000 pancreas transplants were performed by 1994.
  • Pancreas transplantation aims to achieve insulin independence in diabetic patients.
  • Simultaneous pancreas-kidney transplantation (SPKT) and pancreas transplant alone (PTA) are distinct procedures.

Purpose of the Study:

  • To evaluate the outcomes of pancreas transplantation.
  • To determine the indications for pancreas transplantation in diabetic patients.
  • To assess the trade-offs of immunosuppression versus diabetic complications.

Main Methods:

  • Analysis of outcomes for over 6,000 pancreas transplants performed by 1994.
  • Assessment of insulin independence rates at one year post-transplant.
  • Consideration of immunosuppression requirements and patient quality of life.

Main Results:

  • Over 75% of SPKT recipients achieved one-year insulin independence.
  • Approximately 50% of PTA recipients achieved one-year insulin independence.
  • Immunosuppression is a necessary trade-off for PTA in non-uremic patients.

Conclusions:

  • Pancreas transplantation is effective in achieving long-term insulin independence.
  • Routine pancreas transplantation is indicated for diabetic kidney transplant recipients.
  • Pancreas transplantation should be considered for non-uremic patients with severe diabetes lability or hypoglycemia unawareness.

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