[Initial clinical experiences with allotransplantation of the pancreas].
Since 1979 7 pancreas transplantations have been performed in 8 type I diabetics. 5 of these 7 recipients had already been dialysed; 2 were awaiting their first dialysis. Furthermore, diabetes had caused severe retinopathy in 5 patients. The pancreas was transplanted simultaneously with a kidney from the same donor in 5 recipients; in 3 cases the pancreas was grafted 16 to 230 days after successful renal transplantation. 1 pancreas graft was removed immediately after revascularisation because of ischaemic damage. While the pancreatic duct was occluded in the first 4 patients, enteric diversion of the pancreatic juice was applied in the next 3 recipients. The first two patients were treated with conventional immunosuppression, whilst all the others received cyclosporin A and low-dose steroids. Small amounts of insulin had to be given initially for a few days in 2 cases, only. 2 grafts were lost due to surgical complications and 3 for immunological reasons. 1 functioning graft had to be removed because the patient was not willing to continue immunosuppression after irreversible rejection of her renal transplant. There was no perioperative death. 2 pancreatic and 5 renal grafts are functioning well at the present time. Technical aspects and problems in the diagnosis of rejection are discussed.
D000328:Adult; D003524:Cyclosporins / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D003930:Diabetic Retinopathy / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006648:Histocompatibility; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation; D006435:Renal Dialysis; D014184:Transplantation, Homologous
D003524:Cyclosporins
Erste klinische Erfahrungen mit der Allotransplantation des Pankreas.