title: Advances in pancreas transplantation.
abstract: The potential to reverse diabetes has to be balanced against the morbidity of long-term immunosuppression associated with transplantation. For a patient with renal failure, the treatment of choice is often a simultaneous transplant of the pancreas and kidney or pancreas after kidney. For a patient with glycaemic instability, choices between a solid organ or islet transplant have to be weighed against benefits and risks of remaining on insulin. Results of simultaneous transplant of the pancreas and kidney transplantation are comparable to other solid-organ transplants, and there is evidence of improved quality of life and life expectancy. There is some evidence of benefit with respect to the progression of secondary diabetic complications in patients with functioning transplants for several years.
authors.affiliation: Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre, London W12 0HS, UK sham.dholakia@nhs.net.
authors.forename: Shamik
authors.initials: S
authors.lastname: Dholakia
authors.affiliation: Department of Public Health and Primary Care, Imperial College, London W6 8RP, UK.
authors.forename: Youssof
authors.initials: Y
authors.lastname: Oskrochi
authors.affiliation: Department of Public Health and Primary Care, Imperial College, London W6 8RP, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Easton
authors.affiliation: Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre, London W12 0HS, UK.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papalois
mesh_terms: D003920:Diabetes Mellitus / Q000601:surgery*; D038321:Glycemic Index; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D016035:Pancreas Transplantation / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D015996:Survival Rate
keywords: Chronic diseases; endocrinology; evidence-based practice; surgery