title: Pancreas Transplantation: Small-Center Experience in Type 1 Diabetes Mellitus in a High-Incidence Region.
abstract: BACKGROUND
  Pancreas transplantation (PT) is the best option of care for patients with type I diabetes mellitus (T1DM).
  
  
  METHODS
  From July 2005 to September 2014, we performed 27 PT from deceased donors (24 simultaneous pancreas-kidney transplantations [SPKT] and 3 pancreas transplantations alone) in a region with a high incidence of T1DM.
  
  
  RESULTS
  Enteric drainage and systemic venous derivation were accomplished for all PT. Cold and warm ischemia times were 291 ± 70 minutes and 32 ± 9 minutes, respectively. The rate of early re-operations was 33%, mainly because of bleeding occurrence. Mean donor age was 31 ± 11 years; all patients had ABO compatibility and negative cross-match. With a mean follow-up time of 2.3 years, no death was registered. Graft survival of PT was 96.7%, with 1 graft loss in the SPKT group (3.7%) after acute rejection. Nine patients were submitted successfully to re-operation for no life-threatening complications within 30 post-operative days. No early or late episode of vascular thrombosis, pancreatitis, or pancreatic fistula was observed. All patients with a functioning graft had excellent metabolic control, with mean glycosylated hemoglobin level at last follow-up of 5.5% and median fasting glucose level of 95 ± 13 mg/dL, comparable to that in the non-diabetic population.
  
  
  CONCLUSIONS
  In our experience, PT is an excellent therapeutic solution for patients with T1DM. Despite fewer than 5 PT performed per year, graft and patient outcomes were similar to those in high-volume centers.
authors.affiliation: Department of Surgery, Division of General Surgery and Transplantation, Brotzu Hospital, Cagliari, Italy. Electronic address: etondolo@hotmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Tondolo
authors.affiliation: Department of Surgery, Division of General Surgery and Transplantation, Brotzu Hospital, Cagliari, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Manunza
authors.affiliation: Department of Surgery, Division of General Surgery and Transplantation, Brotzu Hospital, Cagliari, Italy.
authors.forename: R A
authors.initials: RA
authors.lastname: Pellegrino
authors.affiliation: Department of Surgery, Division of General Surgery and Transplantation, Brotzu Hospital, Cagliari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Zamboni
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human