title: Development of diabetes mellitus in living pancreas donors and recipients.
abstract: Previously, recurrence of insulin-dependent diabetes mellitus after pancreas transplants was only sporadically reported. Newer data, however, indicate recurrence rates as high as 5%. After identical-twin pancreas transplants, diabetes recurs in the absence of immunosuppressive therapy - strong evidence that it is an autoimmune disease. After deceased donor pancreas transplants, immunologic markers (autoantibodies, autoreactive T cells) herald recurrence. Selective destruction of β cells, still relatively uncommon, is not restricted to MHC compatibility. The development of diabetes in living pancreas donors is rare; it can be largely avoided by meticulous metabolic evaluation before donation and prevention of obesity after donation.
authors.affiliation: Department of Surgery, University of Arizona, Tucson, AZ 85724, USA. rgruessner@surgery.arizona.edu
authors.forename: Rainer W G
authors.initials: RW
authors.lastname: Gruessner
authors.forename: Alberto
authors.initials: A
authors.lastname: Pugliese
authors.forename: Helena K
authors.initials: HK
authors.lastname: Reijonen
authors.forename: Stephan
authors.initials: S
authors.lastname: Gruessner
authors.forename: Tun
authors.initials: T
authors.lastname: Jie
authors.forename: Chirag
authors.initials: C
authors.lastname: Desai
authors.forename: David E R
authors.initials: DE
authors.lastname: Sutherland
authors.forename: George W
authors.initials: GW
authors.lastname: Burke
mesh_terms: D000818:Animals; D015551:Autoimmunity; D003920:Diabetes Mellitus / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D006943:Hyperglycemia; D007165:Immunosuppression Therapy; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000473:pathology; D019520:Living Donors; D009765:Obesity; D016035:Pancreas Transplantation; D010180:Pancreatectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D012306:Risk; D055502:Secondary Prevention; D014180:Transplantation