Current Diabetes Reports

, Volume 12, Issue 5, pp 568–579

Transplantation of the Pancreas

Authors

    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Fabio Vistoli
    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Francesca Maria Egidi
    • Division of NephrologyAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Piero Marchetti
    • Division of MetabolismAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Nelide De Lio
    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Vittorio Perrone
    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Fabio Caniglia
    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Stefano Signori
    • Division of General and Transplant SurgeryAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Massimiliano Barsotti
    • Division of NephrologyAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Matteo Bernini
    • Division of NephrologyAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Margherita Occhipinti
    • Division of MetabolismAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Daniele Focosi
    • Division of ImmunologyAzienda Ospedaliera Universitaria Pisana, Università di Pisa
  • Gabriella Amorese
    • Division of Anesthesia and Intensive CareAzienda Ospedaliera Universitaria Pisana, Università di Pisa
Transplantation (A Pileggi, Section Editor)

DOI: 10.1007/s11892-012-0293-4

Cite this article as:
Boggi, U., Vistoli, F., Egidi, F.M. et al. Curr Diab Rep (2012) 12: 568. doi:10.1007/s11892-012-0293-4

Abstract

Pancreas transplantation consistently induces insulin-independence in beta-cell-penic diabetic patients, but at the cost of major surgery and life-long immunosuppression. One year after grafting, patient survival rate now exceeds 95 % across recipient categories, while insulin independence is maintained in some 85 % of simultaneous pancreas and kidney recipients and in nearly 80 % of solitary pancreas transplant recipients. The half-life of the pancreas graft currently averages 16.7 years, being the longest among extrarenal grafts, and substantially matching the one of renal grafts from deceased donors. The difference between expected (100 %) and actual insulin-independence rate is mostly explained by technical failure in the postoperative phase, and rejection in the long-term period. Death with a functioning graft remains a further major issue, especially in uremic patients who have undergone prolonged periods of dialysis. Refinements in graft preservation, surgical techniques, immunosuppression, and prophylactic treatments are expected to further improve the results of pancreas transplantation.

Keywords

Pancreas transplantationDiabetesInsulin independenceSimultaneous pancreas and kidneyPancreas after kidneyPancreas transplant aloneImmunosuppressionDiabetic complicationsNephropathyRetinopathyPatient survivalGraft SurvivalVascular thrombosis

Copyright information

© Springer Science+Business Media, LLC 2012