title: [Pancreas and islet transplantation in patients with diabetes mellitus].
abstract: 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.
authors.affiliation: Departamento de Cirurgia, Departamento de Medicina, Universidade Federal de São Paulo, SP, Brasil. jrsa@uoll.com.br
authors.forename: João Roberto de
authors.initials: JR
authors.lastname: Sá
authors.forename: Adriano Miziara
authors.initials: AM
authors.lastname: Gonzalez
authors.forename: Cláudio Santiago
authors.initials: CS
authors.lastname: Melaragno
authors.forename: David
authors.initials: D
authors.lastname: Saitovich
authors.forename: Denise Reis
authors.initials: DR
authors.lastname: Franco
authors.forename: Erika Bevilaqua
authors.initials: EB
authors.lastname: Rangel
authors.forename: Irene Lourdes
authors.initials: IL
authors.lastname: Noronha
authors.forename: José Osmar Medina
authors.initials: JO
authors.lastname: Pestana
authors.forename: Marcelo Casaccia
authors.initials: MC
authors.lastname: Bertoluci
authors.forename: Marcelo
authors.initials: M
authors.lastname: Linhares
authors.forename: Marcelo Perosa de
authors.initials: MP
authors.lastname: Miranda
authors.forename: Patricia
authors.initials: P
authors.lastname: Monteagudo
authors.forename: Tércio
authors.initials: T
authors.lastname: Genzini
authors.forename: Freddy Goldberg
authors.initials: FG
authors.lastname: Eliaschewitz
mesh_terms: 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