Diabetes pp 420-437 | Cite as

Pancreatic Transplant in Diabetes

  • Afshin TavakoliEmail author
  • Sue Liong
Part of the Advances in Experimental Medicine and Biology book series (AEMB)


Whole organ pancreas transplantation is increasingly being performed for the treatment of diabetes mellitus. To date, over 32,000 pancreas transplants have been performed worldwide. The procedure is associated with significant mortality and morbidity in early transplant period. However, the successful pancreas transplantation has the potential to render patients insulin-independent and halt the progression of complications of diabetes, thereby improving both quality of life and patient survival.


Pancreas Transplantation Insulin Independence Bladder Drainage Graft Thrombosis Pancreatic Transplant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kelly WD, Lillehei RC, Merkel FK et al. Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy. Surgery 1967; 61(6):827–837.PubMedGoogle Scholar
  2. 2.
    Perosa M, Boggi U, Cantarovich D et al. Pancreas transplantation outside the USA: An update. Cuit Opin Organ Transplant 2011.Google Scholar
  3. 3.
    Reddy KS, Stablein D, Taranto S et al. Long-term survival following simultaneous kidney-pancreas transplantation versus kidney transplantation alone in patients with type 1 diabetes mellitus and renal failure. Am J Kidney Dis 2003; 41(2):464–470.PubMedCrossRefGoogle Scholar
  4. 4.
    Sollinger HW, Odorico JS, Becker YT et al. One thousand simultaneous pancreas-kidney transplants at a single center with 22-year follow-up. Arm Surg 2009; 250(4):618–30Google Scholar
  5. 5.
    Morath C, Zeier M, Dohler B et al. Transplantation of the type 1 diabetic patient: The long-term benefit of a functioning pancreas allograft. Clin J Am Soc Nephrol 2010; 5(3):549–552.PubMedCrossRefGoogle Scholar
  6. 6.
    Navarro X, Sutherland DE, Kennedy WR. Long-term effects of pancreatic transplantation on diabetic neuropathy. Ann Neurol 1997; 42(5):727–736.PubMedCrossRefGoogle Scholar
  7. 7.
    Giannarelli R, Coppelli A, Sartini MS et al. Pancreas transplant alone has beneficial effects on retinopathy in type 1 diabetic patients. Diabetologia 2006; 49(12):2977–2982.PubMedCrossRefGoogle Scholar
  8. 8.
    Fioretto P, Steffes MW, Sutherland DE et al. Reversal of lesions of diabetic nephropathy after pancreas transplantation. N Engl J Med 1998; 339(2):69–75.PubMedCrossRefGoogle Scholar
  9. 9.
    White SA, Shaw JA, Sutherland DE. Pancreas transplantation. Lancet 2009; 373(9677):1808–1817.PubMedCrossRefGoogle Scholar
  10. 10.
    Kaufman DB. Pancreas transplantation clinical presentation. Medscape Reference [serial on internet). 2011 March 16. Available from
  11. 11.
    National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). National diabetes statistics, 2011. Bethesda: National Institutes of Health; 2011 February. Available from
  12. 12.
    Nghiom DD, Cony RJ. Technique of simultaneous renal pancreatoduodenal transplantation with urinary drainage of pancreatic secretion. Am J Surg 1987; 153(4):405–406.CrossRefGoogle Scholar
  13. 13.
    West M, Gruessner AC, Metrakos P et al. Conversion from bladderto enteric drainage after pancreaticoduodenal transplantations. Surgery 1998; 124(5):883–893.PubMedCrossRefGoogle Scholar
  14. 14.
    Monroy-Cuadros M, Salazar A, Yilmaz S et al. Bladder vs enteric drainage in simultaneous pancreas-kidney transplantation. Nephrol Dial Transplant 2006; 21(2):483–487.PubMedCrossRefGoogle Scholar
  15. 15.
    Jimenez-Romero C, Manrique A, Morales JM et al. Conversion from bladder to enteric drainage for complications after pancreas transplantation. Transplant Proc 2009; 41(6):2469–2471.PubMedCrossRefGoogle Scholar
  16. 16.
    Gruessner AC, Sutherland DE. Pancreas transplant outcomes for united states (US) and non-US cases as reported to the united network for organ sharing (UNOS) and the international pancreas transplant registry (IPTR) as of june 2004. Clin Transplant 2005; 19(4):433–455.PubMedCrossRefGoogle Scholar
  17. 17.
    Vaidya A, Muthusamy AS, Hadjianastassiou VG et al. Simultaneous pancreas—kidney transplantation: To anticoagulate or not? is that a question? Clin Transplant 2007; 21(4):554–557.PubMedCrossRefGoogle Scholar
  18. 18.
    Larson TS, Bohorquez II, Rea DJ et al. Pancreas-after-kidney transplantation: An increasingly attractive alternative to simultaneous pancreas-kidney transplantation. Transplantation 2004; 77(6):838–843.PubMedCrossRefGoogle Scholar
  19. 19.
    Dobos N, Roberts DA, Insko EK et al. Contrast-enhanced MR angiography for evaluation of vascular complications of the pancreatic transplant. Radiographies 2005; 25(3):687–695.CrossRefGoogle Scholar
  20. 20.
    Ricart MJ, Malaise J, Moreno A et al. Cytomegalovirus: Occurrence, severity, and effect on graft survival in simultaneous pancreas-kidney transplantation. Nephrol Dial Transplant 2005; 20(Suppl 2):ii25–32, ii62.PubMedCrossRefGoogle Scholar
  21. 21.
    Goodman J, Becker YT. Pancreas surgical complications. Curr Opin Organ Transplant 2009; 14(l):85–89.PubMedCrossRefGoogle Scholar
  22. 22.
    Troppmann C, Gruessner AC, Benedetti E et al. Vascular graft thrombosis after pancreatic transplantation: Univariate and multivariate operative and non-operative risk factor analysis. J Am Coll Surg 1996; 182(4):285–316.PubMedGoogle Scholar
  23. 23.
    Gilabert R, Femandez-Cruz L, Real MI et al. Treatment and outcome of pancreatic venous graft thrombosis after kidney—pancreas transplantation. Br J Surg 2002; 89(3):355–360.PubMedCrossRefGoogle Scholar
  24. 24.
    Hagspiel KD, Nandalur K, Pruett TL et al. Evaluation of vascular complications of pancreas transplantation with high-spatial-resolution contrast-enhanced MR angiography. Radiology 2007; 242(2): 590–599.PubMedCrossRefGoogle Scholar
  25. 25.
    Eubank WB, Schmiedl UP, Levy AE et al. Venous thrombosis and occlusion after pancreas transplantation: Evaluation with breath-hold gadolinium-enhanced three-dimensional MR imaging. AJR Am J Roentgenol 2000; 175(2):381–385.PubMedCrossRefGoogle Scholar
  26. 26.
    Barone GW, Webb JW, Hudec WA. The enteric drained pancreas transplant: Another potential source of gastrointestinal bleeding. Am J Gastroenterol 1998; 93(8): 1369–1371.PubMedCrossRefGoogle Scholar
  27. 27.
    Bingener-Casey J, Esterl RM Jr, Kenneth Washburn W et al. Tc-99m-labeled red blood cell scanning localizes anastomotic hemorrhage between the distal ileum and duodenal stump of an enteric-drained pancreas transplant. Clin Nucl Med 2002; 27(3):205–206.PubMedCrossRefGoogle Scholar
  28. 28.
    Green BT, Tuttle-Newhall J, Suhocki P et al. Massive gastrointestinal hemorrhage due to rupture of a donor pancreatic artery pseudoaneurysm in a pancreas transplant patient. Clin Transplant 2004; 18(1): 108–111.PubMedCrossRefGoogle Scholar
  29. 29.
    Verni MP, Leone JP, DeRoover A. Pseudoaneurysm of the Y-graft/iliac artery anastomosis following pancreas transplantation: A case report and review of the literature. Clin Transplant 2001; 15(l):72–76.PubMedCrossRefGoogle Scholar
  30. 30.
    Tzakis AG, Carroll PB, Gordon RD et al. Arterial mycotic aneurysm and rapture. A potentially fatal complication of pancreas transplantation in diabetes mellitus. Arch Surg 1989; 124(6):660–661.PubMedCrossRefGoogle Scholar
  31. 31.
    Dalla Valle R, Capocasale E, Mazzoni MP et al. Embolization of a ruptured pseudoaneurysm with massive hemorrhage following pancreas transplantation: A case report. Transplant Proc 2005; 37(5):2275–2277.CrossRefGoogle Scholar
  32. 32.
    Patel BK, Garvin PJ, Aridge DL et al. Fluid collections developing after pancreatic transplantation: Radiologic evaluation and intervention. Radiology 1991; 181(l):215–220.PubMedGoogle Scholar
  33. 33.
    Lall CG, Sandrasegaran K, Maglinte DT et al. Bowel complications seen on CT afterpancreas transplantation with enteric drainage. AJR Am J Roentgenol 2006; 187(5):1288–1295.PubMedCrossRefGoogle Scholar
  34. 34.
    Kapoor A. Malignancy in kidney transplant recipients. Drugs 2008; 68Suppl 1:11–19.Google Scholar
  35. 35.
    Gutierrez-Dalmau A, Campistol JM. Immunosuppressive therapy and malignancy in organ transplant recipients: A systematic review. Drags 2007; 67(8):1167–1198.CrossRefGoogle Scholar
  36. 36.
    Issa N, Amer H, Dean PG et al. Posttransplantlymphoproliferative disorder following pancreas transplantation. Am J Transplant 2009; 9(8):1894–1902.PubMedCrossRefGoogle Scholar
  37. 37.
    Meador TL, Krebs TL, Cheong JJ et al. Imaging features of posttransplantation lymphoproliferative disorder in pancreas transplant recipients. AJR Am J Roentgenol 2000; 174(1): 121–124.PubMedCrossRefGoogle Scholar
  38. 38.
    Pickhardt PJ, Siegel MJ. Posttransplantation lymphoproliferative disorder of the abdomen: CT evaluation in 51 patients. Radiology 1999; 213(1):73–78.PubMedGoogle Scholar
  39. 39.
    Collaborative Islet Transplant Registry (CITR). Collaborative islet transplant registry (CITR) 2009 report. Accessed, 2011.Google Scholar
  40. 40.
    The US Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients COPTN/SRTR. Annual report: transplant data 1999–2008. Accessed, 2011.
  41. 41.
    Ryan EA, Paty BW, Senior PA et al. Five-year follow-up after clinical islet transplantation. Diabetes 2005; 54(7):2060–2069.PubMedCrossRefGoogle Scholar
  42. 42.
    Shapiro AM, Ricordi C, Hering BJ et al. International trial of the edmonton protocol for islet transplantation. N Engl J Med 2006; 355(13): 1318–1330.PubMedCrossRefGoogle Scholar
  43. 43.
    Ryan EA, Lakey JR, Paty BW et al. Successful islet transplantation: Continued insulin reserve provides long-term glycemic control. Diabetes 2002; 51(7):2148–2157.PubMedCrossRefGoogle Scholar

Copyright information

© Landes Bioscience and Springer Science+Business Media 2013

Authors and Affiliations

  1. 1.Department of Renal and Pancreas TransplantationManchester Royal InfirmaryManchesterUK
  2. 2.Department of Clinical RadiologyManchester Royal InfirmaryManchesterUK

Personalised recommendations