Pancreas transplantation

Abstract

The transplantation of the pancreas replaces endocrine function of the pancreas, establishes normoglycemia, prevents the progression of chronic diabetic complications and prolongs the patient’s life. The most common indication for transplantation is type 1 diabetes with renal failure, in which the transplantation of both organs is performed simultaneously (approximately 72 % of all transplants) or the transplantation of the pancreas in a patient that already had a kidney transplant. In recent years, the pancreas is also transplanted in selected patients with type 2 diabetes mellitus (approximately 7 % of the transplants). Pancreas-only transplants performed before renal failure are very rare due to narrow indications. Possible complications of transplantation are pancreatic vein or arterial thrombosis, intra-abdominal infections, pancreatitis, pancreatic pseudocyst or fistula, which require relaparotomy in 25–50 % of cases. With upto- date immunosuppression, the survival rate of pancreas transplants has markedly improved; the five-year survival for simultaneous kidney and pancreas transplantation is around 70 %. Even taking into account the possible complications, most authors agree that the simultaneous transplantation of the pancreas and kidney significantly improves the quality of the patient’s life in addition to prolonging life expectancy.