The current state of pancreas transplantation

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

For many patients with type 1 diabetes mellitus and selected patients with type 2 diabetes mellitus, a successful pancreas transplant is the only definitive long-term treatment that both restores euglycaemia without the risk of severe hypoglycaemia and prevents, halts or reverses secondary complications. These benefits come at the cost of major surgery and lifelong immunosuppression. Nevertheless, pancreas transplants are safe and effective, with patient survival rates currently >95% at 1 year and >88% at 5 years; graft survival rates are almost 85% at 1 year and >60% at 5 years. The estimated half-life of a pancreas graft is now 7-14 years. The improvements in graft survival are attributable to considerable reductions in technical failures and in immunologic graft losses. Pancreas recipients have reduced mortality compared with waiting candidates or patients with diabetes mellitus who undergo a kidney transplant alone. Pancreas transplants should be more frequently offered to nonuraemic patients with brittle diabetes mellitus to prevent the development of secondary diabetic complications and to avoid the need for a kidney transplant. Although the results of islet transplantation have also improved, islet recipients rarely maintain long-term insulin independence despite the use of multiple organ donor pancreases. Pancreas transplants and islet transplants should be considered complementary, not mutually exclusive, procedures that are chosen on the basis of the individual patient's surgical risk.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalNature Reviews Endocrinology
Volume9
Issue number9
DOIs
StatePublished - Sep 2013

Fingerprint

Pancreas Transplantation
Pancreas
Transplants
Graft Survival
Type 1 Diabetes Mellitus
Survival Rate
Kidney
Islets of Langerhans Transplantation
Diabetes Complications
Hypoglycemia
Immunosuppression
Type 2 Diabetes Mellitus
Half-Life
Diabetes Mellitus
Tissue Donors
Insulin
Mortality

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

The current state of pancreas transplantation. / Gruessner, Rainer W G; Gruessner, Angelika C.

In: Nature Reviews Endocrinology, Vol. 9, No. 9, 09.2013, p. 555-562.

Research output: Contribution to journalArticle

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