From Wikipedia, the free encyclopedia

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (November 2008)

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who has diabetes. Because the pancreas performs functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas attached in a different location. In the event of rejection of the new pancreas, the recipient could not survive without the native pancreas still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor. ^[1] Whole pancreas transplants from living donors are not possible, again because the pancreas is a necessary organ for digestion. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes who have severe complications.

[edit] Types

There are three main types of pancreas transplantation:

• Simultaneous pancreas-kidney transplant (SPK), when the pancreas and kidney are transplanted simultaneously from the same deceased donor.
• Pancreas-after-kidney transplant (PAK), when a cadaveric, or deceased, donor pancreas transplant is performed after a previous, and different, living or deceased donor kidney transplant.
• Pancreas transplant alone, for the patient with type 1 diabetes who usually has severe, frequent hypoglycemia, but adequate kidney function.

[edit] Indications

In most cases, pancreas transplantation is performed on individuals with type 1 diabetes with end-stage renal disease The majority of pancreas transplantations (>90%) are simultaneous pancreas-kidney transplantions.^[2]

[edit] Preservation until implantation

The donor's blood in the pancreatic tissue will be replaced by an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft pancreatic tissue is implanted.

[edit] Complications

Complications immediately after surgery include rejection, thrombosis, pancreatitis and infection.

[edit] Prognosis

The prognosis after pancreas transplantation is very good. Over the recent years, long-term success has improved and risks have decreased. One year after transplantation more than 95% of all patients are still alive and 80-85% of all pancreases are still functional. After transplantation patients need lifelong immunosuppression. Immunosuppression increases the risk for a number of different kinds of infection^[3] and cancer.

[edit] History

The first pancreas transplantation was performed in 1966 by the team of Dr. Kelly, Dr. Lillehei, Dr.Merkel, Dr.Idezuki Y, & Dr. Goetz, three years after the first kidney transplantation.^[4] A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantation, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

[edit] References

• Larsen JL (2004). "Pancreas transplantation: indications and consequences". Endocr Rev 25 (6): 919–46. doi:10.1210/er.2002-0036. PMID 15583023.  Full text
• International Pancreas transplantation Association sjhfk okjbhuiewthjkhkjbYRJKY7RHIOUYRBHIO7IOHIOUBDFLSJYVljbhhd98u jdhjnw8rn b879hkl 13jjbgriu

[edit] External links

• Diabetes Institute for Immunology and Transplantation
• International Pancreas transplantation Association