title: Single-center experience with pancreas transplantation.
abstract: BACKGROUND
  Recently improved patient and graft survivals, as well as decreased of postoperative morbidity have ushered in pancreas transplantation (PT) due to technical refinements as well as better immunosuppression and postoperative management. Herein we analyzed the outcomes of PT over a 19-year experiences at a single center.
  
  
  METHODS
  All recipients who underwent deceased donor or living donor PT from July 1992 to July 2011 were enrolled in this study. We reviewed their medical records, including operative records, as well as clinical and laboratory findings. We analyzed graft and patient survival rates using the Kaplan-Meier method.
  
  
  RESULTS
  One hundred fifty-three cases were performed between July 1992 and July 2011. The indication for PT was type I diabetes in 125 (81.7%), and type II diabetes in 28 (18.3%) patients. The pancreas donor was deceased in 139 (90.8%) and living in 14 cases (9.2%). The type of PT was simultaneous pancreas-kidney transplantation (n = 91, 59.5%), pancreas alone (n = 49; 32.0%), or pancreas after kidney (n = 13, 8.5%). Median follow-up was 43.0 months (range 0-228). At 1, 5, and 10 years overall patient survivals were 93.8%, 88.1%, and 85.1%, and graft survivals, 82.3%, 70.6%, and 64.6%, respectively. When we divided the deceased donor PT recipients into two groups according to when they underwent PT (up to 2005 [n = 54]) vs 2006 and later [n = 85]), the recent group showed significantly improved patient and graft survival rates (P < .001). With no difference between type I (n = 65) and type II (n = 20) patients (P = .159).
  
  
  CONCLUSIONS
  Considering the improved quality of life and long-term patient survival, PT can be an effective treatment strategy in diabetic patients requiring insulin regardless of type of disorder.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: J B
authors.initials: JB
authors.lastname: Park
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.forename: K B
authors.initials: KB
authors.lastname: Song
authors.forename: Y S
authors.initials: YS
authors.lastname: Chung
authors.forename: H J
authors.initials: HJ
authors.lastname: Jang
authors.forename: J-Y
authors.initials: JY
authors.lastname: Park
authors.forename: S-C
authors.initials: SC
authors.lastname: Kim
authors.forename: D J
authors.initials: DJ
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000401:mortality; D011788:Quality of Life; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin