Advances in pancreas transplantation.
Despite early obstacles impacting the success of pancreatic transplantation, the introduction of new procedures and new immunosuppressive therapies during the past 2 decades has improved outcomes for pancreatic transplant recipients. For example, the use of bladder drainage and better human leukocyte antigen matching has helped overcome some of the early obstacles of pancreatic transplantation. In addition, the introduction of tacrolimus in 1994 and mycophenolate mofetil in 1996 has helped lower rates of acute rejection and increase graft survival, with less nephrotoxicity than treatment with cyclosporine. Regimens allowing the tapering of corticosteroids have also helped reduce the rates of acute pancreas rejection. To further improve therapeutic options for patients with type 1 diabetes or end-stage renal disease, pancreatic islet transplantation and organ and islet xenotransplantation should be further explored.
Burke
George W
GW
Lillian Jean Kaplan Renal Transplantation Center, University of Miami/Jackson Memorial Medical Center, Miami, FL 33136, USA.
Ciancio
Gaetano
G
Sollinger
Hans W
HW
D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016381:Islets of Langerhans Transplantation; D016035:Pancreas Transplantation / Q000009:adverse effects; D016559:Tacrolimus / Q000627:therapeutic use
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016559:Tacrolimus