Pancreas transplantation: review.

Publisher: Instituto de Ensino e Pesquisa Albert Einstein Country of Publication: Brazil NLM ID: 101281800 Publication Model: Print Cited Medium: Internet ISSN: 2317-6385 (Electronic) Linking ISSN: 16794508 NLM ISO Abbreviation: Einstein (Sao Paulo) Subsets: MEDLINE

Original Publication: São Paulo, SP : Instituto de Ensino e Pesquisa Albert Einstein

Postoperative Complications*; Diabetes Mellitus, Type 1/*surgery ; Graft Rejection/*complications ; Infections/*complications ; Pancreas Transplantation/*methods; Brazil ; Diabetes Mellitus, Type 1/mortality ; Donor Selection/standards ; Humans ; Immunosuppression Therapy/methods ; Pancreas Transplantation/mortality ; Survival Rate ; Transplant Recipients ; United States

Vascularized pancreas transplantation is the only treatment that establishes normal glucose levels and normalizes glycosylated hemoglobin levels in type 1 diabetic patients. The first vascularized pancreas transplant was performed by William Kelly and Richard Lillehei, to treat a type 1 diabetes patient, in December 1966. In Brazil, Edison Teixeira performed the first isolated segmental pancreas transplant in 1968. Until the 1980s, pancreas transplants were restricted to a few centers of the United States and Europe. The introduction of tacrolimus and mycophenolate mofetil in 1994, led to a significant outcome improvement and consequently, an increase in pancreas transplants in several countries. According to the International Pancreas Transplant Registry, until December 31st, 2010, more than 35 thousand pancreas transplants had been performed. The one-year survival of patients and pancreatic grafts exceeds 95 and 83%, respectively. The better survival of pancreatic (86%) and renal (93%) grafts in the first year after transplantation is in the simultaneous pancreas-kidney transplant group of patients. Immunological loss in the first year after transplant for simultaneous pancreas-kidney, pancreas after kidney, and pancreas alone are 1.8, 3.7, and 6%, respectively. Pancreas transplant has 10 to 20% surgical complications requiring laparotomy. Besides enhancing quality of life, pancreatic transplant increases survival of uremic diabetic patient as compared to uremic diabetic patients on dialysis or with kidney transplantation alone.

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Date Created: 20150709 Date Completed: 20151020 Latest Revision: 20211203

20250114

PMC4943828

10.1590/S1679-45082015RW3163

26154551