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History of Pancreas Transplantation

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Transplantation of the Pancreas

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Abstract

The symptoms of diabetes mellitus (polyuria) were first described some 3500 years ago. A general understanding of the anatomy of the pancreas was provided almost 2000 years ago. But it was not until the seventeenth century that the anatomy of the pancreas was fully appreciated. The function of the pancreas was explored in the nineteenth century. But it was not until the experiments by Mering and Minkowski in the late nineteenth century that explained its relationship to diabetes. Only then was the dual nature of the pancreas understood. The first attempt at transplanting pancreatic tissue took place in 1893, almost three decades before the discovery of insulin. After it was realized that exogenous insulin administration would not cure diabetes, experimental pancreas transplants continued in the first half of the twentieth century until Kelly and Lillehei performed the first pancreas transplant in a human on December 17, 1966. Since then and through 2020, over 65,000 pancreas transplants have been performed worldwide. The evolution of pancreas transplantation from an experimental to a standard surgical procedure took decades and included improvements in surgical techniques, immunosuppressive regimens, polymicrobial prophylaxis and therapy, posttransplant care, and follow-up. Many transplant surgeons have contributed to the now standardized technique of whole-organ pancreaticoduodenal transplantation with systemic venous and enteric drainage. Antibody induction therapy and triple maintenance immunosuppression have become standard of care. Despite improvements in exogenous insulin therapy through advanced medical devices and islet transplantation, pancreas transplantation remains the only consistent long-term treatment for patients to become insulin-independent and normoglycemic. Over the past few decades, a plethora of literature has shown that pancreas transplantation not only achieves freedom from insulin, but also cessation and even reversal of secondary diabetic complications.

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  1. University of Minnesota, Minneapolis, MN, USA

    David E. R. Sutherland

  2. Department of Surgery, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA

    Rainer W. G. Gruessner

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    Rainer W. G. Gruessner

  2. Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Angelika C. Gruessner

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Sutherland, D.E.R., Gruessner, R.W.G. (2023). History of Pancreas Transplantation. In: Gruessner, R.W.G., Gruessner, A.C. (eds) Transplantation of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-031-20999-4_5

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