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Long-Term Pancreas Graft Function

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Transplantation of the Pancreas

Abstract

As with other solid-organ (kidney, liver, heart) recipients, the number of pancreas recipients with 10-year graft function and beyond is steadily increasing. These recipients enjoy long-term normoglycemic metabolism without the need for multiple daily plasma glucose measurements and insulin injections. As shown in chapter 16, they also benefit from the positive effects of long-term pancreas graft function on the secondary complications of diabetes. Long-term pancreas graft function, therefore, not only improves quality of life (see chapter 17) but also markedly reduces the morbidity and mortality traditionally associated with type 1 diabetes mellitus and its secondary complications. Recipients with long-term function are also a constant reminder that a pancreas transplant, despite numerous improvements in the treatment of diabetes mellitus (see chapter 3), remains the only treatment that normalizes glucose metabolism for as long as the graft functions.

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References

  1. Gruessner AC. Analysis of the International Pancreas Transplant Registry. Personal communication; February 2001.

    Google Scholar 

  2. Bruce DS, Newell KA, Josephson MA, et al. Long-term outcome of kidney—pancreas transplant recipients with good graft function at one year. Transplantation 1996; 62: 451–456.

    Article  PubMed  CAS  Google Scholar 

  3. Gruessner RWG, Sutherland DER, Dunn DL, et al. >10 year follow-up after pancreas transplantation. Am J Transplant 2001; 1: S160.

    Google Scholar 

  4. Stratta RJ. Mortality after vascularized pancreas transplantation. Surgery 1998; 124: 823–830.

    Article  PubMed  CAS  Google Scholar 

  5. Burke GW, Ciancio G, Olson L, et al. Ten-year survival after simultaneous pancreas/kidney transplantation with bladder drainage and tacrolimus-based immunosuppression. Transplant Proc 2001; 33: 1681–1683.

    Article  PubMed  CAS  Google Scholar 

  6. Lo A, Stratta RJ, Hathaway DK, et al. Long-term outcomes in simultaneous kidney-pancreas transplant recipients with portal-enteric versus systemic-bladder drainage. Transplant Proc 2001; 33: 1684–1686.

    Article  PubMed  CAS  Google Scholar 

  7. Light JA, Sasaki TM, Currier CB, et al. Successful long-term kidney-pancreas transplants regardless of C-peptide status or race. Transplantation 2001; 71: 152–154.

    Article  PubMed  CAS  Google Scholar 

  8. Sudan D, Sudan R, Stratta R. Long-term outcome of simultaneous kidney-pancreas transplantation. Analysis of 61 patients with more than 5 years follow-up. Transplantation 2000; 69: 550–555.

    Article  PubMed  CAS  Google Scholar 

  9. Gliedman ML, Tellis VA, Soberman R, et al. Long-term effects of pancreatic transplant function in patients with advanced juvenile-onset diabetes. Diabetes Care 1978; 1: 1–9.

    Article  PubMed  CAS  Google Scholar 

  10. Najarian JS, Gruessner AC, Drangstveit MB, et al. Insulin independence for more than 10 years in 32 pancreas transplant recipients from an historical era. Transplant Proc 1998; 30: 279.

    Article  PubMed  CAS  Google Scholar 

  11. Stratta RJ, Gaber AO, Shokouh-Amiri MH, et al. Nine-year experience with 126 pancreas transplants with portal-enteric drainage. Transplant Proc 2001; 33: 1687–1688.

    Article  PubMed  CAS  Google Scholar 

  12. Bechstein WO. Long-term outcome of pancreas transplantation. Transplant Proc 2001; 33: 1652–1654.

    Article  PubMed  CAS  Google Scholar 

  13. Gruessner RWG, Stephanian E, Dunn DL, et al. Cystoenteric conversion after whole pancreaticoduodenal transplantation. Transplant Proc 1993; 25: 1179–1181.

    PubMed  CAS  Google Scholar 

  14. Bloom RD, Olivares M, Rehman L, et al. Long-term pancreas allograft outcome in simultaneous pancreas-kidney transplantation. A comparison of enteric and bladder drainage. Transplant 1997; 64: 1689–1695.

    Article  CAS  Google Scholar 

  15. Nakhleh RE, Gruessner RWG, Tzardis PJ, et al. Pathology of transplanted human duodenal tissue: A histologic study, with comparison to pancreatic pathology in resected pancreaticoduodenal transplants. Clin Transplantation 1991; 5: 241–247.

    Google Scholar 

  16. Tajra LCF, Dawhara M, Benchaib M, et al. Effect of the surgical technique on long-term outcome of pancreas transplantation. Transplant Int 1998; 11: 295–300.

    Article  Google Scholar 

  17. Nymann T, Shokouh-Amiri MH, Elmer DS, et al. Diagnosis, management, and outcome of late duodenal complications in portal-enteric pancreas transplantation: Case report. J Am Coll Surg 1997; 185: 560–566.

    Article  PubMed  CAS  Google Scholar 

  18. Hakim NS, Gruessner AC, Papalois BE, Troppmann C, Dunn DL, Sutherland DER, Gruessner RWG. Duodenal complications in bladder-drained pancreas transplantation. Surgery 1997; 121: 618–624.

    Article  PubMed  CAS  Google Scholar 

  19. Gruessner RWG, Stephanian E, Dunn DL, Gruessner AC, Najarian JS, Sutherland DER. Cystoenteric conversion after whole pancreaticoduodenal transplantation. Transplant Proc 1993; 25: 1179–1181.

    PubMed  CAS  Google Scholar 

  20. Martin X, Tajra LCF, Benchaib M, et al. Long-term outcome of pancreas transplantation. Transplant Proc 1997; 29: 2423–2424.

    Article  PubMed  CAS  Google Scholar 

  21. Illner WD, Abendroth D, Nusser J, et al. Long-term results in pancreatic transplantation with special emphasis on the use of prolamine Diabetologia 1991; 34: S14 - S15.

    Google Scholar 

  22. Cantarovich D, Paineau J, Karam G, et al. Five-year experience with segmental duct-occluded pancreatic grafts. Transplant Proc 1994; 26: 416.

    PubMed  CAS  Google Scholar 

  23. Illner WD, Schneeberger H, Hofmann G, et al. Duct occlusion-induced vascularized islet grafts are not associated with progressive long-term dysfunction. Transplant Proc 1995; 27: 1342 1343.

    Google Scholar 

  24. Tajra LCF, Dubernard JM, Dawhara M, et al. Long-term outcome of segmental duct injected pancreas: Three to 13 years survival. Transplant Proc 1998; 30: 297–298.

    Article  PubMed  CAS  Google Scholar 

  25. Lo A, Stratta RJ, Egidi MF, et al. Outcome of simultaneous kidney-pancreas transplantation in African-American recipients: A case control study. Transplant Proc 2001; 33: 1675–1677.

    Article  PubMed  CAS  Google Scholar 

  26. Douzdjian V, Thacker LR, Blanton JW. Effect of race on outcome following kidney and kidney-pancreas transplantation in type I diabetics: The Southeastern Organ Procurement Foundation experience. Clin Transplant 1997; 11: 470–475.

    PubMed  CAS  Google Scholar 

  27. Cheung AHS, Sutherland DER, Gillingham KJ, et al. Simultaneous pancreas-kidney transplant versus kidney transplant alone in diabetic patients. Kidney Int 1992; 41: 924–929.

    Article  PubMed  CAS  Google Scholar 

  28. Manske CL, Wang Y, Thomas W. Mortality of cadaveric kidney transplantation versus combined kidney-pancreas transplantation in diabetic patients. Lancet 1995; 346: 1658–1662.

    Article  PubMed  CAS  Google Scholar 

  29. Douzdjian V, Abecassis MM, Cony RJ, et al. Simultaneous pancreas-kidney versus kidney-alone transplants in diabetics: Increased risk of early cardiac death and acute rejection following pancreas transplants. Clin Transplant 1994; 8: 246–251.

    PubMed  CAS  Google Scholar 

  30. Douzdjian V, Rice JC, Gugliuzza KK, et al. Renal allograft and patient outcome after transplantation: Pancreas-kidney versus kidney-alone transplants in type 1 diabetic patients versus kidney-alone transplants in nondiabetic patients. Am J Kidney Dis 1996; 27: 106–116.

    Article  PubMed  CAS  Google Scholar 

  31. Smets YFC, Westendorp RGJ, van der Pijl JW, et al. Effect of simultaneous pancreas-kidney transplantation on mortality of patients with type-1 diabetes mellitus and end-stage renal failure. Lancet 1999; 353: 1915–1919.

    Article  PubMed  CAS  Google Scholar 

  32. Tyden G, Bolinder J, Solders G, et al. Improved survival in patients with insulin-dependent nephropathy 10 years after combined pancreas and kidney transplantation. Transplantation 1999; 67: 645–648.

    Article  PubMed  CAS  Google Scholar 

  33. Becker BN, Brazy PC, Becker YT, et al. Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int 2000; 57: 2129–2135.

    Google Scholar 

  34. LaRocca E, Fiorina P, Astorri E, et al. Patient survival and cardiovascular events after kidney-pancreas transplantation: Comparison with kidney transplantation alone in uremic IDDM patients. Cell Transplantation 2000; 9: 929–932.

    CAS  Google Scholar 

  35. Rayhill SC, D’Alessandro AM, Odorico JS, et al. Simultaneous pancreas-kidney transplantation and living related donor renal transplantation in patients with diabetes: Is there a difference in survival? Ann Surg 2000; 231: 417–423.

    Article  PubMed  CAS  Google Scholar 

  36. Lee CM, Scandling JD, Krieger NR, et al. Outcomes in diabetic patients after simultaneous pancreas-kidney versus kidney alone transplantation. Transplantation 1997; 64: 1288–1294.

    Article  PubMed  CAS  Google Scholar 

  37. Ojo AO, Meier-Kriesche HU, Hanson JA, et al. The impact of simultaneous pancreas-kidney transplantation on long-term patient survival. Transplantation 2001; 71: 82–90.

    Article  PubMed  CAS  Google Scholar 

  38. Reddy KS, Stablein D, Taranto S, et al. Long-term survival following simultaneous kidney—pancreas transplantation versus kidney transplantation alone in patients with type 1 diabetes mellitus and renal failure. Transplant Proc 2001; 33: 1659–1660.

    Article  PubMed  CAS  Google Scholar 

  39. Sutherland DER, Gruessner RWG, Dunn DL, et al. Lessons learned from more than 1,000 pancreas transplants at a single institution. Ann Surg 2001; 233: 463–501.

    Article  PubMed  CAS  Google Scholar 

  40. Brattstrom C, Tibell A, Tyden G, et al. Outcome in 22 patients with pancreas transplants functioning beyond 5 years. Transplant Proc 1994; 26: 414–415.

    PubMed  CAS  Google Scholar 

  41. Troppmann C, Gruessner RWG, Matas AJ, et al. Results with renal transplants performed after previous solitary pancreas transplants. Transplant Proc 1994; 26: 448–449.

    PubMed  CAS  Google Scholar 

  42. Gruessner RWG, Sutherland DER, Najarian JS, et al. Solitary pancreas transplantation for nonuremic patients with labile insulin-dependent diabetes mellitus. Transplantation 1997; 64: 1572–1577.

    Article  PubMed  CAS  Google Scholar 

  43. Gruessner AC, Sutherland DER, Dunn DL, et al. Pancreas after kidney transplants in posturemic patients with type I diabetes mellitus. J Am Soc Nephrol 2001; 12: 2490–2499.

    PubMed  CAS  Google Scholar 

  44. Stratta RJ, Sudan R, Sudan D. Long-term outcomes in simultaneous kidney—pancreas transplant recipients. Transplant Proc 1998; 30: 1564–1565.

    Article  PubMed  CAS  Google Scholar 

  45. McCauley J, Shapiro R, Jordan ML, et al. Long-term lipid metabolism in combined kidney—pancreas transplant recipients under tacrolimus immunosuppression. Transplant Proc 2001; 33: 1698–1699.

    Article  PubMed  CAS  Google Scholar 

  46. Martinenghi S, Dell’Antonio G, Secchi A, et al. Cancer arising after pancreas and/or kidney transplantation in a series of 99 diabetic patients. Diabetes Care 1997; 20: 272–275.

    Article  PubMed  CAS  Google Scholar 

  47. Morrissey PE, Shaffer D, Monaco AP, et al. Peripheral vascular disease after kidney—pancreas transplantation in diabetic patients with end-stage renal disease. Arch Surg 1997; 132: 358–362.

    Article  PubMed  CAS  Google Scholar 

  48. Biesenbach G, Margreiter R, Konigsrainer A, et al. Comparison of progression of macrovascular diseases after kidney or pancreas and kidney transplantation in diabetic patients with end-stage renal disease. Diabetologia 2000; 43: 231–234.

    Article  PubMed  CAS  Google Scholar 

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© 2004 Springer Science+Business Media New York

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Gruessner, R.W.G., Gruessner, A.C. (2004). Long-Term Pancreas Graft Function. In: Gruessner, R.W.G., Sutherland, D.E.R. (eds) Transplantation of the Pancreas. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4371-5_18

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  • DOI: https://doi.org/10.1007/978-1-4757-4371-5_18

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1830-7

  • Online ISBN: 978-1-4757-4371-5

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