Evolution of pancreas transplant surgery.
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.
Lam
Vincent W T
VW
National Pancreas Transplant Unit, Westmead Hospital, New South Wales, Australia.
Pleass
Henry C C
HC
Hawthorne
Wayne
W
Allen
Richard D M
RD
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
D001786:Blood Glucose