title: Pancreas transplantation: problems and prospects in intensive care units.
abstract: OBJECTIVE
  The aim of this study is to describe personal experience in the intensive management of patients with severe diabetes undergoing pancreas transplantation.
  
  
  METHODS
  Clinical records of subjects consecutively undergoing an isolated or combined pancreas transplant have been examinated.
  
  
  RESULTS
  During the considered period, 10 patients received an isolated pancreas transplant and 43 a simultaneous kidney-pancreas transplantation (SPKT), including 6 using a kidney from a living donor. The mean stay in the Intensive Care Unit (ICU) was 4.7 days: 52 patients (98.2%) were transferred to the Surgical Department, whereas one (1.8%) belonging to the SPKT group died with a non-functioning graft. Ten patients (18.6%) were re-admitted because of the onset of late complications, including one SPKT who died of sudden cardiac death with functioning grafts. Arterial hypertension appeared in 51% of the recipients, and 5.6% experienced at least one hypotensive episode. Cardiac rhythm alterations were diagnosed in 5 subjects (9.4%), and myocardial ischemia in 9 (17%).
  
  
  CONCLUSIONS
  Pancreas transplantation is a therapeutic option that can improve patients' quality of life by also slowing down the evolution of diabetes; however, it is important to bear in mind the associated risks. The best results are obtained in patients in whom the disease has not already seriously impaired the function of the various target organs.
authors.affiliation: Postoperative Intensive Care and Transplantation Unit, Department of Anesthesia and Resuscitation I, Cisanello Hospital, 56100 Pisa, Italy. l.bindi@ao-pisa.toscana.it
authors.forename: M L
authors.initials: ML
authors.lastname: Bindi
authors.forename: G
authors.initials: G
authors.lastname: Biancofiore
authors.forename: C
authors.initials: C
authors.lastname: Pasquini
authors.forename: D
authors.initials: D
authors.lastname: Lugli
authors.forename: G
authors.initials: G
authors.lastname: Amorese
authors.forename: G
authors.initials: G
authors.lastname: Bellissima
authors.forename: N
authors.initials: N
authors.lastname: Fossati
authors.forename: L
authors.initials: L
authors.lastname: Meacci
authors.forename: S
authors.initials: S
authors.lastname: Nardi
authors.forename: M
authors.initials: M
authors.lastname: Pieri
authors.forename: F
authors.initials: F
authors.lastname: Vistoli
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.forename: A
authors.initials: A
authors.lastname: Sansevero
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000601:surgery; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality; D012189:Retrospective Studies