Short Review Of The Pancreas Transplant

The survival and success rates for pancreas transplants have improved during recent years. By 1997, almost 10,000 such transplants had been done.

According to the International Pancreas Transplant Registry, first-year graft survival rates between 1994 and 1997 were 82 percent for a simultaneous kidney-pancreas transplant, 71 percent when a pancreas was transplanted after a kidney transplantation and 62 percent when a pancreas was transplanted alone. Type 1 patients with renal failure are encouraged to have a pancreas transplant at the same time as or after a kidney transplantation, because it is easier to detect rejection by measuring the serum creatinine produced by the kidney. When successful, a pancreas-kidney transplantation can restore normal blood sugars and insulin levels for five to 20 years.

Although islet transplantations are less invasive than a pancreas transplant, they are also less successful. Data from the 1990—1995 International Islet Transplant Registry shows that only 6 percent of type 1 recipients were free from insulin shots or pumps one year after transplant. Recipients of islet, as well as organ, transplants often need to take powerful immunosuppressants for life. These drugs usually come with adverse side effects.

According to the ADA, islet cell transplantation should be considered an experimental procedure at this stage and should be performed in a controlled research setting.

Pancreas transplantations are usually recommended for people who have had type 1 diabetes for 20 or more years. Like any major surgery, the procedure is risky and also requires recipients to take powerful immunosuppressants for life. Also, transplantation has not been wholly successful in reversing long-term damage inflicted by kidney disease and neuropathy. There is no guarantee that the islet-destroying autoimmune process will cease with transplantation.

-Diabetes Care, January 2000

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