title: Transplantation of the pancreas.
abstract: Pancreas transplantation consistently induces insulin-independence in beta-cell-penic diabetic patients, but at the cost of major surgery and life-long immunosuppression. One year after grafting, patient survival rate now exceeds 95 % across recipient categories, while insulin independence is maintained in some 85 % of simultaneous pancreas and kidney recipients and in nearly 80 % of solitary pancreas transplant recipients. The half-life of the pancreas graft currently averages 16.7 years, being the longest among extrarenal grafts, and substantially matching the one of renal grafts from deceased donors. The difference between expected (100 %) and actual insulin-independence rate is mostly explained by technical failure in the postoperative phase, and rejection in the long-term period. Death with a functioning graft remains a further major issue, especially in uremic patients who have undergone prolonged periods of dialysis. Refinements in graft preservation, surgical techniques, immunosuppression, and prophylactic treatments are expected to further improve the results of pancreas transplantation.
authors: Division of General and Transplant Surgery, Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Via Paradisa 2, 56124, Pisa, Italy. u.boggi@med.unipi.it
authors: Ugo
authors: U
authors: Boggi
authors: Fabio
authors: F
authors: Vistoli
authors: Francesca Maria
authors: FM
authors: Egidi
authors: Piero
authors: P
authors: Marchetti
authors: Nelide
authors: N
authors: De Lio
authors: Vittorio
authors: V
authors: Perrone
authors: Fabio
authors: F
authors: Caniglia
authors: Stefano
authors: S
authors: Signori
authors: Massimiliano
authors: M
authors: Barsotti
authors: Matteo
authors: M
authors: Bernini
authors: Margherita
authors: M
authors: Occhipinti
authors: Daniele
authors: D
authors: Focosi
authors: Gabriella
authors: G
authors: Amorese
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy / Q000628:therapy; D006085:Graft Survival; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods; D016035:Pancreas Transplantation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007328:Insulin