title: Evolution of pancreas transplant surgery.
abstract: BACKGROUND
  Type 1 diabetes mellitus is a chronic condition often leading to disabling complications including retinopathy, neuropathy and cardiovascular disease which can be modified by intensive treatment with insulin. Such treatment, however, is associated with a restrictive lifestyle and risk of hypoglycaemic morbidity and mortality.
  
  
  METHODS
  This review examines the role of pancreas transplantation in patients with Type 1 diabetes mellitus.
  
  
  RESULTS
  Pancreas transplantation is currently the only proven option to achieve long-term insulin independence, resulting in an improvement or stabilization of those diabetic related complications. The hazards of pancreas transplantation as a major operation are well known. Balancing the risks of a surgical procedure, with the benefits of restoring normoglycaemia remains an important task for the pancreas transplant surgeon. Pancreas transplantation is not an emergency operation to treat poorly managed and non-compliant patients with debilitating complications. It is a highly specialized procedure which has evolved both in terms of the surgical technique, patient selection and assessment.
  
  
  CONCLUSIONS
  Pancreas transplantation has emerged as the single most effective way to achieve normal glucose homeostasis in patients with Type 1 diabetes mellitus.
authors.affiliation: National Pancreas Transplant Unit, Westmead Hospital, New South Wales, Australia.
authors.forename: Vincent W T
authors.initials: VW
authors.lastname: Lam
authors.forename: Henry C C
authors.initials: HC
authors.lastname: Pleass
authors.forename: Wayne
authors.initials: W
authors.lastname: Hawthorne
authors.forename: Richard D M
authors.initials: RD
authors.lastname: Allen
mesh_terms: D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D006801:Humans; D010179:Pancreas / Q000098:blood supply / Q000601:surgery; D016035:Pancreas Transplantation; D010180:Pancreatectomy / Q000379:methods; D018579:Patient Selection; D009927:Tissue and Organ Procurement
chemical_list: D001786:Blood Glucose