Living Donor Pancreas Transplantation

  • Rainer W. G. Gruessner


The concept of solid-organ donation for transplantation is virtually unique among surgical procedures in that a healthy volunteer is exposed to the risks of surgery solely for the benefit of another individual. The first successful living related kidney transplant (between monozygous twins) was performed by Joseph Murray in Boston in 1954.1 He later recalled the ethical, legal, medical, and surgical concerns that he faced at that time, overcome by finding broad support in the legal, religious, and medical communities.2 For his pioneering work, Murray was awarded the Nobel Prize in medicine in 1990.


Distal Pancreatectomy Living Donor Donor Nephrectomy Cadaver Donor Live Kidney Donor 
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  1. 1.
    Murray JE, Merrill JP, Harrison JH. Renal homotransplantation in identical twins. Surg Forum 1955; 6: 432–436.Google Scholar
  2. 2.
    Murray JE. The first successful organ transplants in man. Scand J Immunol 1994; 39: 1–11.PubMedGoogle Scholar
  3. 3.
    Annual Report of the US Scientific Reports of Transplant Recipients and the Organ Procurement and Transplantation Network. Rockville, MD: US Department of Health and Human Services, Health Resources and Services Administration; 2000.Google Scholar
  4. 4.
    Dicken SCK, Cosimi AB. The donor and donor nephrectomy. In: Morris PJ, ed. Kidney Transplantation-Principles and Practice. 5th ed. Philadelphia: WB Saunders Co, 2001: 89–105.Google Scholar
  5. 5.
    Childress JF. Who Should Decide? Oxford, UK: Oxford University Press, 1982.Google Scholar
  6. 6.
    Fellner CH, Marshall JR. Kidney donors: The myth of informed consent. Am J Psychiatry 1970; 126: 1245–1251.PubMedGoogle Scholar
  7. 7.
    Franldin PM. Psychological aspects of kidney transplantation and organ donation. In: Morris, PJ, ed. Kidney Transplantation-Principles and Practice. 5th ed. Philadelphia: WB Saunders Co, 2001: 716–731.Google Scholar
  8. 8.
    Simmons RG, Hickey K, Kjellstrand CM, Simmons RL. Donors and non-donors: The role of the family and the physician in kidney transplantation. Sem Psychiatry 1971; 3: 102–115.Google Scholar
  9. 9.
    Surman OS. Psychiatric considerations of organ transplantation. In: Ginns LC, Cosimi AB, Morris PJ, eds. Transplantation. Malden, MA: Blackwell Science; 1999: 709–724.Google Scholar
  10. 10.
    O’Connor KJ, Delmonico FL. Donor selection and management. In: Ginns LC, Cosimi AB, Morris PJ, eds. Transplantation. Malden, MA: Blackwell Science; 1999: 239–270.Google Scholar
  11. 11.
    Salahudeen A, Woods HF, Pingle A, et al. High mortality among recipients of bought living-unrelated donor kidneys. Lancet 1990; 336: 725–728.PubMedCrossRefGoogle Scholar
  12. 12.
    Quinibi W, Abulrub D, Shaheen R, el-Din A, et al. Attitudes of commercial renal transplant recipients toward renal transplantation in India. Clin Transplant 1995; 9: 317–321.Google Scholar
  13. 13.
    Lei C, Abdullah K, Morad Z, Suleiman A Surgical complications of living unrelated kidney transplantations in a Third-World country. Transplant Proc 1992; 24: 1815.PubMedGoogle Scholar
  14. 14.
    UNOS Ethics Committee. Ethics of organ transplantation from living donors. Transplant Proc 1992; 24: 2236–2237.Google Scholar
  15. 15.
    Spital A. Should children ever donate kidneys? Views of U.S. transplant centers. Transplantation 1997; 64: 232–236.PubMedCrossRefGoogle Scholar
  16. 16.
    Masden-Harrison. Massachusetts Supreme Judicial Court, Equity Number 68651; 1957.Google Scholar
  17. 17.
    Simmons RG, Klein SD, Simmons RL. The Gift of Life: The Social and Psychological Impact of Organ Transplantation. New York: John Wiley & Sons; 1977.Google Scholar
  18. 18.
    Jacobs C, Johnson E, Anderson K, Gillingham K, Matas A. Kidney transplants from living donors: How donation affects family dynamics Adv Renal Ther 1998; 5: 89–97.Google Scholar
  19. 19.
    Cecka M. The UNOS Scientific Renal Transplant Registry-2000. In: Cecka JM, Terasaki PI, eds. Clinical Transplants 2000. Los Angeles: UCLA Immunogenetics Center, 2000: 1–18.Google Scholar
  20. 20.
    Kasiske BL, Ravenscraft M, Ramos EL, et al. The evaluation of living renal transplant donors: Clinical practice guidelines. Ad Hoc Clinical Practice Guidelines Subcommittee of the Patient Care and Education Committee of the American Society of Transplant Physicians. J Am Soc Nephrol 1996; 7: 2288–2313.PubMedGoogle Scholar
  21. 21.
    Jones J, Payne WD, Matas AJ. The living donor-risks, benefits, and related concerns. Transplant Rev 1993; 7: 115–128.CrossRefGoogle Scholar
  22. 22.
    Johnson EM, Remucal MJ, Gillingham KJ, et al. Complications and risks of living donor nephrectomy. Transplantation 1997; 64: 1124–1128.PubMedCrossRefGoogle Scholar
  23. 23.
    Merrill JP. Moral problems of artificial and transplanted organs. Ann Intern Med 1964; 61: 355–363.Google Scholar
  24. 24.
    Fehrman-Ekholm I, Brink B, Ericsson C, et al. Kidney donors don’t regret: Follow-up of 370 donors in Stockholm since 1964. Transplantation 2000; 69: 2067–2071.PubMedCrossRefGoogle Scholar
  25. 25.
    Fehrman-Ekholm I, Elinder CG, Stenbeck M, et al. Kidney donors live longer. Transplantation 1997; 64: 976–978.PubMedCrossRefGoogle Scholar
  26. 26.
    Spital A. Life insurance for kidney donors-an update. Transplantation 1988; 45 (4–6): 819–820.PubMedGoogle Scholar
  27. 27.
    Spital A, Kokmen, T. Health insurance for kidney donors. How easy is it to obtain ? Transplantation 1996; 62: 1356–1358.PubMedCrossRefGoogle Scholar
  28. 28.
    Najarian JS, Chavers BM, McHugh LE, Matas AJ. 20 years or more of follow-up of living kidney donors. Lancet 1992; 340: 807–810.PubMedCrossRefGoogle Scholar
  29. 29.
    Bay WH, Heber LA. The living donor in kidney transplantation. Ann Intern Med 1987; 106: 719–727.PubMedGoogle Scholar
  30. 30.
    Anderson CF, Velosa JA, Frohnert PP, et al. The risks of unilateral nephrectomy: Status of kidney donors 10 to 20 years postoperatively. Mayo Clin Proc 1985; 60: 367–374.PubMedCrossRefGoogle Scholar
  31. 31.
    Raia S, Nery JR, Mies S. Liver transplantation from live donors. Lancet 1989; II: 497.Google Scholar
  32. 32.
    Broelsch CE, Whitington PF, Emond JC, et al. Liver transplantation in children from living related donors: Surgical techniques and results. Ann Surg 1991; 214: 428–439.PubMedCrossRefGoogle Scholar
  33. 33.
    Starnes VA, Lewiston NJ, Luikart H, Theodore J, Stinson EB, Shumway NE. Current trends in lung transplantation: Lobar transplantation and expanded use of single lungs. J Thorac Cardiovasc Surg 1992;104:1060–1065. Discussion.Google Scholar
  34. 34.
    Starnes V, Barr M, Cohen R. Lobar transplantation; indications, technique, and outcome. J Thorac Cardiovasc Surg 1994; 108: 403–411.PubMedGoogle Scholar
  35. 35.
    Fortner JG, Sichuk G, Litwin SD, et al. Immunological responses to an intestinal allograft with HLA identical donor recipient. Transplantation 1972; 14: 531–535.PubMedCrossRefGoogle Scholar
  36. 36.
    Gruessner RWG, Sharp HL. Living related intestinal transplantation-first report of a standardized surgical technique. Transplantation 1997; 64: 1605–1607.PubMedCrossRefGoogle Scholar
  37. 37.
    Sutherland DER, Goetz FC, Najarian JS. Living-related donor segmental pancreatectomy for transplantation. Transplant Proc 1980; 12: 19–25.PubMedGoogle Scholar
  38. 38.
    Gruessner A. IPTR analysis. Personal communication; 2001.Google Scholar
  39. 39.
    Gruessner RWG, Najarian JS, Gruessner AC, Sutherland DER. Pancreas transplants from living related donors. In: Touraine JL, Traeger J, Bétuel H, et al., eds. Organ Shortage-The Solutions. Dordrecht, The Netherlands: Kluwer Academic; 1995: 77–83.CrossRefGoogle Scholar
  40. 40.
    Sutherland DER, Gruessner R, Dunn D, Moudry-Munns K, Gruessner A, Najarian JS. Pancreas transplants from living-related donors. Transplant Proc 1994; 26: 443–445.PubMedGoogle Scholar
  41. 41.
    Gruessner RWG, Sutherland DER. Simultaneous kidney and segmental pancreas transplants from living related donors-the first two successful cases. Transplantation 1996; 61: 1265 1268.Google Scholar
  42. 42.
    Benedetti E, Dunn T, Massad MG, Raofi V, Bartholomew A, Gruessner RWG, Brecklin C. Successful living related simultaneous pancreas-kidney transplant between identical twins. Transplantation 1999; 67: 915–918.PubMedCrossRefGoogle Scholar
  43. 43.
    Nelson PW, Landreneau MD, et al. Ten-year experience in transplantation of A2 kidneys into B and O recipients. Transplantation 1998; 65: 256.PubMedCrossRefGoogle Scholar
  44. 44.
    Alexandre GPJ, Squifflet JP. Significance of the ABO antigen system. In: Cirelli GJ, ed. Organ Transplantation and Replacement. Philadelphia: JB Lippincott, 1988: 230.Google Scholar
  45. 45.
    Barbosa J, King R, Noreen H, Yunis EJ. The histocompatibility system in juvenile, insulin-dependent diabetic multiplex kindreds. J Clin Invest 1977; 60: 989–998.PubMedCrossRefGoogle Scholar
  46. 46.
    Gavard JA, Becker DJ. Familial insulin-dependent diabetes mellitus and hemipancreatectomy. Lancet 1993; 341: 303–304.PubMedCrossRefGoogle Scholar
  47. 47.
    Kendall DM, Sutherland DER, Najarian JS, Goetz FC, Robertson RP. Effects of hemipancreatectomy on insulin secretion and glucose tolerance in healthy humans. N Engl J Med 1990; 322: 898–903.PubMedCrossRefGoogle Scholar
  48. 48.
    Gruessner RWG, Kendall DM, Drangstveit MB, Gruessner AC, Sutherland DER. Simultaneous pancreas-kidney transplantation from live donors. Ann Surg 1997; 226: 471–482.PubMedCrossRefGoogle Scholar
  49. 49.
    McGuire EAH, Helderman JH, Tobin JD, Andres R, Berman M. Effects of arterial versus venous sampling on analysis of glucose kinetics in man. J Appl Physiol 1976; 41: 565–573.PubMedGoogle Scholar
  50. 50.
    Seaquist ER, Robertson RP. Effects of hemipancreatectomy on pancreatic a and ß cell function in healthy human donors. J Clin Invest 1992; 89: 1761–1766.PubMedCrossRefGoogle Scholar
  51. 51.
    Halter JB, Graf RI, Porte D Jr. Potentiation of insulin secretory responses by plasma glucose levels in maw Evidence that hyperglycemia in diabetes compensates for impaired glucose potentiation. J Clin Invest 1984; 48: 946–954.Google Scholar
  52. 52.
    Ward WK, Bolgiano DC, McKnight B, Halter JB, Porte D Jr. Diminished /3 cell secretory capacity in patients with non-insulin-dependent diabetes mellitus. J Clin Invest 1984; 74: 1318–1328.PubMedCrossRefGoogle Scholar
  53. 53.
    Kandaswamy R, Stillman AE, Granger DK, Sutherland DER, Gruessner RW. MRI is superior to angiography for evaluation of living-related simultaneous pancreas and kidney donors. Transplant Proc 1999; 31: 604–605.PubMedCrossRefGoogle Scholar
  54. 54.
    Gruessner RWG, Kandaswamy R, Denny R. Laparoscopic simultaneous nephrectomy and distal pancreatectomy from a live donor. J Am Coll Surg 2001; 1993: 333–337.CrossRefGoogle Scholar
  55. 55.
    Crass JR, Frick MP, Loken MK. The scintigraphic appearance of the spleen following splenic artery resection. Radiology 1980; 136: 737–739.PubMedGoogle Scholar
  56. 56.
    Sutherland DER, Goetz FC, Najarian JS. Pancreas transplants from related donors. Transplantation 1984; 38: 625–633.PubMedCrossRefGoogle Scholar
  57. 57.
    Seaquist ER, Kahn SE, Clark PM, Hales CN, Porte D Jr., Robertson RP. Hyperproinsulinemia is associated with increased ß l3 cell demand after hemipancreatectomy in humans. J Clin Invest 1996; 97: 455–460.PubMedCrossRefGoogle Scholar
  58. 58.
    Bolinder J, Gunnarsson R, Tydén G, Brattström C, Östman J, Groth CG. Metabolic effects of living related pancreatic graft donation. Transplant Proc 1988; 20: 475–478.PubMedGoogle Scholar
  59. 59.
    Gruessner RWG, Sutherland DER, Drangstveit MB, Bland BJ, Gruessner AC. Pancreas transplants from living donors: Short-and long-term outcome. Transplant Proc 2001; 33: 819–820.PubMedCrossRefGoogle Scholar
  60. 60.
    Sutherland DER, Najarian JS, Gruessner R. Living versus cadaver donor pancreas transplants. Transplant Proc 1998; 30: 2264–2266.PubMedCrossRefGoogle Scholar
  61. 61.
    Gruessner RWG, Leone JP, Sutherland DER. Combined kidney and pancreas transplants from living donors. Transplant Proc 1998; 30: 282.PubMedCrossRefGoogle Scholar
  62. 62.
    Sutherland DER, Sibley RK, Xu XZ, et al. Twin-to-twin pancreas transplantation: Reversal and reenactment of the pathogenesis of type 1 diabetes. Trans Assoc Am Physicians 1984; 97: 80–87.PubMedGoogle Scholar
  63. 63.
    Gruessner RWG. Should priority on the waiting list be given to patients with diabetes: Pro. Transplant Proc. 2002; 34: 1575–1576.CrossRefGoogle Scholar
  64. 64.
    Iglehart JK. The American health care system: The end-stage renal disease program. N Engl J Med 1993; 328: 366–371.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 2004

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  • Rainer W. G. Gruessner

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