title: Current status of pancreas transplantation.
abstract: To review recent pancreas transplantation outcomes and indications and describe studies of the impact of pancreas transplant upon patient survival and secondary complications.
  
  
  
  A number of surgical advances have occurred that have improved the early success rate of transplant, and modern immunosuppressive strategies have improved the rate of longer term allograft survival. Pancreas transplant is associated with a mortality benefit when performed in patients with end-stage renal disease in combination with kidney transplant, but questions regarding the impact upon secondary diabetic complications together with the risk assumed by the surgical procedure and the attendant immunosuppression in the nonuremic patient may have tempered enthusiasm for broader expansion of transplantation. Thus, despite these advances, the number of pancreas transplants performed annually is falling consistently. Efforts to define optimal donor and recipient characteristics and understand the pathophysiological impact of pancreas transplant are active areas of research that may lead to greater expansion of pancreas transplant in the future.
  
  
  
  The review summarizes these advances, including the utilization patterns of pancreas transplant and current concepts of patient selection and graft monitoring, and places into perspective the current and future role of pancreas transplantation as a therapeutic option in diabetes.
authors.affiliation: aDivision of Renal Diseases and Hypertension bDivision of Transplant Surgery, Transplant Center, University of Colorado Denver, Denver, Colorado, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Stites
authors.forename: Peter
authors.initials: P
authors.lastname: Kennealey
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Wiseman
mesh_terms: D048909:Diabetes Complications / Q000150:complications / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D016035:Pancreas Transplantation; D018579:Patient Selection; D015996:Survival Rate