Pancreas transplantation for treatment of diabetes mellitus.
Pancreas transplantation is the only treatment for type I diabetes mellitus that can induce an insulin-independent normoglycemic state. Because of the need for immunosuppression, it has been most widely applied in uremic diabetic recipients of kidney transplant with a high success rate, particularly when done as a simultaneous (SPK) procedure (insulin independence > 80% at 1 year) with patient and kidney graft survival rates equivalent to or higher than in those who receive a kidney transplant alone. The results of solitary pancreas transplants (PAK in nephropathic diabetic recipients or PTA in nonuremic recipients) have also dramatically improved; 1-year graft survival rates are more than 80% and 70%, respectively, with the new immunosuppressants tacrolimus and mycophenolate mofetil. Multiple factors are important for successful application of pancreas transplantation, as summarized in this review.
Sutherland
D E
DE
Department of Surgery, University of Minnesota, Mayo Mail Code 280, 420 Delaware Street SE, Minneapolis, Minnesota 55455, USA.
Gruessner
R W
RW
Gruessner
A C
AC
D003920:Diabetes Mellitus / Q000378:metabolism / Q000601:surgery*; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D019520:Living Donors; D016035:Pancreas Transplantation / Q000276:immunology / Q000379:methods / Q000401:mortality; D018579:Patient Selection; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D016559:Tacrolimus