Pancreas transplantation

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one which can produce insulin) into a person who has diabetes. Typically, the recipient's existing pancreas is not removed. The healthy pancreas comes from a donor who has just died or from a living relative. A person can donate half a pancreas and still live normally. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes who have severe complications. This is because after the transplant the patient must take immunosuppressive drugs that are highly toxic and may cause damage to the body; for a majority of diabetics, a lifetime on insulin is a better option.

Types

There are three main types of pancreas transplantation:

Simultaneous pancreas-kidney transplant: the pancreas and kidney are transplanted simultaneously from the same deceased donor.
Pancreas-after-kidney transplant: a cadaveric, or deceased, donor pancreas transplant is performed after a previous, and different, living or deceased donor kidney transplant.
Pancreas transplant alone: for the patient with type 1 diabetes who usually has severe, frequent hypoglycemia, but adequate kidney function.

Indications

In most cases, pancreas transplantation is performed on individuals with type 1 diabetes with end-stage renal disease, but sometimes also type 2 diabetes. The majority of pancreas transplantations (>90%) are simultaneous pancreas-kidney transplantions.

Complications

Complications immedeately after surgery include rejection, thrombosis, pancreatitis and infection.

Prognosis

The prognosis after pancreas transplantation is very good. Over the recent years, long-term success has improved and risks have decreased. One year after transplantation more than 95% of all patients are still alive and 80-85% of all pancreases are still functional. After transplantation patients need lifelong immunosuppression. Immunosuppression increases the risk for a number of different kinds of infection Full text and cancer.

History

The first pancreas transplantation was performed in 1966, three years after the first kidney transplantation. A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantatiom, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

References

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