Evolution of kidney, pancreas, and islet transplantation for patients with diabetes at the University of Minnesota

David E R Sutherland, Paul F. Gores, Alan C. Farney, David C. Wahoff, Arthur J. Matas, David L. Dunn, Rainer W G Gruessner, John S. Najarian

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Transplantation began at the University of Minnesota in 1963. Treatment of diabetes and its complications has been emphasized since 1966, when the first pancreas-kidney transplant was done. Of 3,640 kidneys transplanted by 1992, 1,373 were for diabetic recipients, including 658 from living donors and 715 from cadaver donors. The results progressively improved; since 1984, survival rates of kidney grafts have been similar for diabetic and nondiabetic recipients, with three fourths of the grafts functioning at 4 years. As of 1992, 501 pancreas transplants had been done, including 170 simultaneous with a kidney, 142 after a kidney, and 188 alone for nonuremic diabetic patients; again, the results have improved: by the 1990s, graft survival rates were similar in the 3 recipient categories. Successful pancreas transplants have been shown by our coworkers to stabilize or improve neuropathy and prevent recurrence of diabetic nephropathy in kidney grafts. In an attempt to simplify endocrine replacement therapy, we have done 63 human islet transplants, 34 as allografts for patients with type I diabetes and 29 as autografts after total pancreatectomy to treat chronic pancreatitis. Insulin independence occurs for about 50% of islet autograft recipients. Two recent islet allograft recipients treated with 15-deoxyspergualin have had sustained insulin independence. We anticipate that endocrine replacement therapy by transplantation will become routine for diabetic patients as methods to prevent rejection are refined.

Original languageEnglish (US)
Pages (from-to)456-491
Number of pages36
JournalAmerican Journal of Surgery
Volume166
Issue number5
DOIs
StatePublished - 1993
Externally publishedYes

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Pancreas Transplantation
Islets of Langerhans Transplantation
Kidney Transplantation
Transplants
Kidney
Pancreas
Autografts
Allografts
Survival Rate
Transplantation
Insulin
Pancreatectomy
Living Donors
Chronic Pancreatitis
Diabetic Nephropathies
Graft Survival
Diabetes Complications
Type 1 Diabetes Mellitus
Cadaver
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Sutherland, D. E. R., Gores, P. F., Farney, A. C., Wahoff, D. C., Matas, A. J., Dunn, D. L., ... Najarian, J. S. (1993). Evolution of kidney, pancreas, and islet transplantation for patients with diabetes at the University of Minnesota. American Journal of Surgery, 166(5), 456-491. https://doi.org/10.1016/S0002-9610(05)81142-0

Evolution of kidney, pancreas, and islet transplantation for patients with diabetes at the University of Minnesota. / Sutherland, David E R; Gores, Paul F.; Farney, Alan C.; Wahoff, David C.; Matas, Arthur J.; Dunn, David L.; Gruessner, Rainer W G; Najarian, John S.

In: American Journal of Surgery, Vol. 166, No. 5, 1993, p. 456-491.

Research output: Contribution to journalArticle

Sutherland, David E R ; Gores, Paul F. ; Farney, Alan C. ; Wahoff, David C. ; Matas, Arthur J. ; Dunn, David L. ; Gruessner, Rainer W G ; Najarian, John S. / Evolution of kidney, pancreas, and islet transplantation for patients with diabetes at the University of Minnesota. In: American Journal of Surgery. 1993 ; Vol. 166, No. 5. pp. 456-491.
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