Pancreas transplantation

From Wikipedia, the free encyclopedia

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who has diabetes. Typically, the recipient's existing pancreas is removed. The healthy pancreas comes from a donor who has just died or from a living relative. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes who have severe complications.

Contents 1 Types 2 Indications 3 Complications 4 Prognosis 5 History 6 References 7 External Links

[edit] Types

There are three main types of pancreas transplantation:

• Simultaneous pancreas-kidney transplant, when the pancreas and kidney are transplanted simultaneously from the same deceased donor.
• Pancreas-after-kidney transplant, when 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.

[edit] Indications

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

[edit] Complications

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

[edit] 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^[2] and cancer.

[edit] History

The first pancreas transplantation was performed in 1966, three years after the first kidney transplantation.^[3] A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantation, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

[edit] References

1. ^ Gruessner AC, Sutherland DE (2005). "Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004". Clin Transplant 19 (4): 433-55. PMID 16008587. 
2. ^ Fishman JA, Rubin RH (1998). "Infection in organ-transplant recipients". N Engl J Med 338 (24): 1741-51. PMID 9624195.  Full text
3. ^ Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC (1967). "Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy". Surgery 61 (6): 827-37. PMID 5338113. 

• Larsen JL (2004). "Pancreas transplantation: indications and consequences". Endocr Rev 25 (6): 919-46. PMID 15583023.  Full text
• International Pancreas transplantation Association

[edit] External Links

• Diabetes Institute for Immunology and Transplantation
• International Pancreas transplantation Association