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Anaesthetic Management for Patients Undergoing Pancreas Transplantation

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Anesthesia for Hepatico-Pancreatic-Biliary Surgery and Transplantation

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Abstract

A significant percentage of the general population is diabetic. Diabetes mellitus can be managed with oral medication, insulin injections, or continuous infusion of insulin via an insulin pump. Despite significant improvement in the treatment of diabetes, there are still patients with long-lasting and poorly managed disease. Diabetes mellitus can lead to numerous complications, including nephropathy, coronary artery disease, peripheral vascular disease, heart failure, and autonomic and peripheral neuropathy. Pancreas transplantation, indicated mainly in patients with poorly controlled diabetes, characterized by hypoglycaemic unawareness and multiple hypoglycaemic episodes. The results of pancreatic transplantation are improving with increased operator experience, as well as improved donor graft quality, immunosuppression, surgical techniques, and perioperative care. The benefits of pancreatic transplantation include a reduced need for daily injections of insulin, and the stabilisation of complications such as nephropathy, autonomic and peripheral neuropathy, and atherosclerosis. A shortage of donors is the main obstacle to carrying out pancreatic transplantation surgery. In addition to transplantation of the pancreas, pancreatic islet cell transplantation may be performed. Although this procedure is performed mainly under local anaesthesia, the use of general anaesthesia is increasingly common. In this chapter, we will describe anaesthetic perioperative management for pancreatic transplantation.

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Abbreviations

SPKTx:

Simultaneous pancreas kidney transplant

PAKTx:

Pancreas after kidney transplant

PTx:

Pancreas transplant alone

BMI:

Body mass index

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Authors and Affiliations

  1. Amrita Institute of Medical Sciences, Kochi, India

    Lakshmi Kumar & Ramachandran N. Menon

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  1. Lakshmi Kumar
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  2. Ramachandran N. Menon
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Correspondence to Lakshmi Kumar .

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Editors and Affiliations

  1. Department of Anaesthesia, King's College Hospital, London, UK

    Zoka Milan

  2. King's College Hospital, London, UK

    Chula Goonasekera

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Kumar, L., Menon, R.N. (2021). Anaesthetic Management for Patients Undergoing Pancreas Transplantation. In: Milan, Z., Goonasekera, C. (eds) Anesthesia for Hepatico-Pancreatic-Biliary Surgery and Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-030-51331-3_25

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  • DOI: https://doi.org/10.1007/978-3-030-51331-3_25

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