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Pancreas transplantation: a review

D E Sutherland1, A C Gruessner, R W Gruessner

  • 1Department of Surgery, University of Minnesota, Minneapolis 55455, USA.

Transplantation Proceedings
|September 2, 1998
PubMed
Summary

Pancreas transplantation offers insulin independence and a dialysis-free state for uremic diabetic patients. While islet transplantation is less successful, pancreas transplants remain a highly effective treatment for diabetes complications.

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What defines success in pancreas and islet transplantation-insulin independence or prevention of hypoglycemia? A review.

Transplantation proceedings·2014

Area of Science:

  • Transplantation Medicine
  • Endocrinology
  • Nephrology

Background:

  • Pancreas transplantation is a standard treatment for uremic diabetic patients, often performed with kidney transplants.
  • Successful pancreas transplants lead to insulin independence and cessation of dialysis.
  • Pancreas transplantation alone is less common due to immunosuppression requirements but offers significant benefits for select patients.

Purpose of the Study:

  • To evaluate the efficacy and role of pancreas transplantation in managing diabetic complications.
  • To compare pancreas transplantation with islet transplantation for endocrine replacement therapy.
  • To inform diabetologists about treatment augmentation options for diabetic patients.

Main Methods:

  • Review of outcomes for simultaneous pancreas-kidney transplantation and pancreas-after-kidney transplantation.
  • Analysis of results from pancreas transplantation alone for insulin independence.
  • Assessment of islet allograft success rates from historical data and ongoing trials.

Main Results:

  • Pancreas transplantation provides insulin independence and can improve secondary diabetic complications, including neuropathy.
  • Pancreas transplants alone are a viable option for patients with labile diabetes or unawareness of hypoglycemia.
  • Islet transplantation has shown lower insulin independence rates (less than 10% at 1 year) compared to pancreas transplantation.

Conclusions:

  • Pancreas transplantation is a highly effective treatment for achieving insulin independence in diabetic recipients.
  • Islet transplantation shows promise but currently has significantly lower success rates than pancreas transplantation.
  • Candidates for endocrine replacement therapy should be informed about the superior success rates of pancreas transplantation.

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