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Pancreas Transplantation

  • Gabriele SpoletiniEmail author
  • Steven A. White
Chapter
Part of the In Clinical Practice book series (ICP)

Abstract

Pancreas transplantation (PTX) is the sole long-term option for the restoration of euglycemia in diabetic patients. Due to the risk of morbidity, non-insignificant mortality and need for lifelong immunosuppression, PTX has been limited to selected patients over the years. Also, thank to improved results with islet transplantation and more sophisticated automated insulin release devices, there has been a trend towards less utilization of solid organ PTX in the last decade. Depending on the presence of associated diabetic nephropathy, recipients of a PTX may have received a kidney transplant already (PAK) or need a simultaneous kidney-pancreas transplant (SPK). Conversely, the pancreas is transplanted alone (PTA) in patients on maximal insulin treatment but still with poor metabolic control or hypoglycemic unawareness. Patients and grafts outcomes have been steadily improving over the decades, accompanied by better quality of life. There is evidence that diabetes-related complications can be halted and in some cases partly reverted by a long lasting functional PTX. Advances in technology for insulin delivery and glucose monitoring, improved results with islet transplantation, the potential development of gene therapy, bioengineering and stem cell research, they all seem to limit the future role of solid organ PTX that however is still the most durable and consistent option for beta cell replacement therapy in insulin-depleted diabetics.

Keywords

Pancreas transplantation Diabetes Islet transplantation Beta-cell replacement 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Transplant Surgery Unit, Freeman Hospital, Newcastle Upon Tyne HospitalsNewcastleUK

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