Pancreas transplantation.
Since the introduction of pancreas transplantation more than 40 years ago, efforts to develop more minimally invasive techniques for endocrine replacement therapy have been in progress, yet this surgical procedure still remains the treatment of choice for diabetic patients with end-stage renal failure. Many improvements have been made in the surgical techniques and immunosuppressive regimens, both of which have contributed to an increasing number of indications for pancreas transplantation. This operation can be justified on the basis that patients replace daily injections of insulin with an improved quality of life but at the expense of a major surgical procedure and lifelong immunosuppression. The various indications, categories, and outcomes of patients having a pancreas transplant are discussed, particularly with reference to the effect on long-term diabetic complications.
White
Steve A
SA
Department of Hepatopancreatobiliary and Transplantation Surgery, Freeman Hospital, Newcastle upon Tyne, Tyne and Wear, UK. steve.white@nuth.nhs.uk
Shaw
James A
JA
Sutherland
David E R
DE
D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D048909:Diabetes Complications / Q000209:etiology / Q000601:surgery*; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D009017:Morbidity; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods / Q000639:trends; D018579:Patient Selection; D011788:Quality of Life; D015996:Survival Rate; D009927:Tissue and Organ Procurement; D014181:Transplantation Immunology; D016896:Treatment Outcome