[Pancreas and islet transplantation in patients with diabetes mellitus].
Pancreas and kidney transplants have specific indications, benefits and risks. The procedure has become more common and more often as long-term success has improved and risks have decreased. Compared with a patient being on dialysis, simultaneous pancreas-kidney transplant offers a distinct advantage when it comes to mortality, quality of life and diabetic complications. Since there can be a living-donor kidney transplant,, a possibly similar patient and graft survival by 10 years follow-up, this procedure should be considered. Pancreas after kidney transplants, when successful, can improve microvascular complications compared with kidney transplant alone, but immediate mortality may be higher. Solitary pancreas transplantation can improve the quality of life in selected patients, but it may also increase the immediate risk of mortality due to the complexity of the surgery and the risks of immunosupression. The results of Islet transplantation differ from the higher metabolic performance achieved by whole pancreas allotransplantation and its applicability is limited to selected adult diabetic patients.
Sá
João Roberto de
JR
Departamento de Cirurgia, Departamento de Medicina, Universidade Federal de São Paulo, SP, Brasil. jrsa@uoll.com.br
Gonzalez
Adriano Miziara
AM
Melaragno
Cláudio Santiago
CS
Saitovich
David
D
Franco
Denise Reis
DR
Rangel
Erika Bevilaqua
EB
Noronha
Irene Lourdes
IL
Pestana
José Osmar Medina
JO
Bertoluci
Marcelo Casaccia
MC
Linhares
Marcelo
M
Miranda
Marcelo Perosa de
MP
Monteagudo
Patricia
P
Genzini
Tércio
T
Eliaschewitz
Freddy Goldberg
FG
D000328:Adult; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000401:mortality; D003928:Diabetic Nephropathies / Q000209:etiology / Q000401:mortality; D003929:Diabetic Neuropathies / Q000209:etiology / Q000401:mortality; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010179:Pancreas / Q000098:blood supply; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome