Clinical segmental pancreatic transplantation.
Pancreatic transplantation is still partly experimental. Its role in halting the progression of secondary complications of insulin-dependent diabetics has not been completely defined. Although pancreaticoduodenal transplantation has been used since 1966, it was not until 1977 that modifications in the surgical technique allowed for encouraging results when segmental pancreatic transplantation was utilized. During the last year, we have performed five segmental pancreatic transplants in insulin-dependent, preuremic juvenile diabetics. Postoperatively these patients received immunosuppression consisting of azathioprine, prednisolone and antilymphoblast globulin (ALG). These patients were followed-up by serial pancreatic echograms and pancreatic scans. All patients except the first one became normoglycemic following transplantation. Serum insulin reached normal levels within a few days post-transplantation. Pancreatitis was evident in the immediate postoperative period. The last four patients showed evidence of rejection in the form of increasing blood sugar levels and need of insulin for control of hyperglycemia. Two of these patients were treated with ALG (10 doses) and local radiation to the graft (150 r x 3), and the other two patients were treated with high doses of oral and intravenous steroids. Postoperative pancreatitis and rejection are still the two main problems that are seen after pancreatic transplantation. Better immunosuppressive agents are needed to improve long-term results.
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000517:prevention & control; D003929:Diabetic Neuropathies / Q000517:prevention & control; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D016035:Pancreas Transplantation; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications
D007166:Immunosuppressive Agents