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Pancreas Transplantation

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Type 1 Diabetes

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Pancreas transplantation is viewed by many as a last resort for diabetic patients undergoing great difficulty controlling their glucose levels despite intensive medical management, which usually involves a trial of continuous subcutaneous insulin infusion through a portable pump. Relegation of pancreas transplantation to the position of last resort arguably results in its not being considered as often as it should be. Even in the 21st century, when we know the success rate for pancreas transplantation is comparable to those for other organs, this procedure is not considered as often as is transplantation of the liver, kidney, lung, and heart.

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References

  1. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–986.

    Article  Google Scholar 

  2. Rizza RA, Cryer PE, Gerich JE. Role of glucagon, catecholamines, and growth hormone in human glucose counterregulation. Effects of somatostatin and combined alpha- and beta-adrenergic blockade on plasma glucose recovery and glucose flux rates after insulin-induced hypoglycemia. J Clin Invest 1979;64:62–71.

    Article  PubMed  CAS  Google Scholar 

  3. Bolli G, de Feo P, Compagnucci P, Cartechini MG, Angeletti G, Santeusanio F, et al. Abnormal glucose counterregulation in insulin-dependent diabetes mellitus: interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion. Diabetes 1983;32:134–141.

    Article  PubMed  CAS  Google Scholar 

  4. Kleinbaum J, Shamoon H. Impaired counterregulation of hypoglycemia in insulin-dependent diabetes mellitus. Diabetes 1983;32:493–498.

    Article  PubMed  CAS  Google Scholar 

  5. Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unawareness, but not detective glucose counterregulation, in IDDM. Diabetes 1994;43:1426–1434.

    Article  PubMed  CAS  Google Scholar 

  6. Fanelli CG, Epifano L, Rambotti AM, Pampanelli S, Di Vincenzo A, Modarelli F, et al. Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 1993;42:1683–1689.

    Article  PubMed  CAS  Google Scholar 

  7. Davis M, Mellman M, Friedman S, Chang CJ, Shamoon H. Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes. Am J Med 1994;97:535–542.

    Article  PubMed  CAS  Google Scholar 

  8. Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC. Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy. Surgery 1967;61:827–837.

    PubMed  CAS  Google Scholar 

  9. Robertson RP. American Diabetes Association Position Statement: Pancreas transplantation for patients with type 1 diabetes. Diabetes Care 2000;23:S85.

    Article  Google Scholar 

  10. Diem P, Abid M, Redmon JB, Sutherland DE, Robertson RP. Systemic venous drainage of pancreas allografts as independent cause of hyperinsulinemia in type I diabetic recipients. Diabetes 1990;39:534–540.

    Article  PubMed  CAS  Google Scholar 

  11. Gruessner AC, Sutherland DE. Pancreas transplants for United States (US) and non-US cases as reported to the International Pancreas Transplant Registry (IPTR) and to the United Network for Organ Sharing (UNOS). Clin Transplant 1997;45–59.

    Google Scholar 

  12. International Islet Transplant Registry, Vol 6, No. 1, December 1996.

    Google Scholar 

  13. Robertson RP, Sutherland DE, Kendall DM, Teuscher AU, Gruessner RW, Gruessner A. Metabolic characterization of long-term successful pancreas transplants in type I diabetes. J Investig Med 1996;44:1–7.

    Google Scholar 

  14. Robertson RP, Sutherland DER, Lanz KJ. Normoglycemia and preserved insulin secretory reserve in diabetic patients 10 to 18 years after pancreas transplantation. Diabetes 1999;48:1737–1740.

    Article  PubMed  CAS  Google Scholar 

  15. Delaunay F, Kahn A, Cintra A, Davani B, Ling Z-C, Andersson A, et al. Pancreatic beta cells are important targets for the diabetogenic effects of glucocorticoids. J Clin Invest 1997;100:2094–2098.

    Article  PubMed  CAS  Google Scholar 

  16. Yale JF, Roy RD, Grose M, Seemayer TA, Murphy GF, Marliss EB. Effects of cyclosporine on glucose tolerance in the rat. Diabetes 1985;34:1309–1313.

    Article  PubMed  CAS  Google Scholar 

  17. Robertson RP. Cyclosporin-induced inhibition of insulin secretion in isolated rat islets and HIT cells. Diabetes 1986;35:1016–1019.

    Article  PubMed  CAS  Google Scholar 

  18. Odocha O, McCauley J, Scantlebury V, Shapiro R, Carroll P, Jordan M, et al. Posttransplant diabetes mellitus in African Americans after renal transplantation under FK 506 immunosuppression. Transplant Proc 1993;25:2433–2434.

    PubMed  CAS  Google Scholar 

  19. Herold KC, Nagamatsu S, Buse JB, Kulsakdinun P, Steiner DF. Inhibition of glucose-stimulated insulin release from beta TC3 cells and rodent islets by an analog of FK506. Transplantation 1993;55:186–192.

    Article  PubMed  CAS  Google Scholar 

  20. Tamura K, Fujimura T, Tsutsumi T, Nakamura K, Ogawa T, Atumaru C, et al. Transcriptional inhibition of insulin by FK506 and possible involvement of FK506 binding protein-12 in pancreatic betacell. Transplantation 1995;59:1606–1613.

    PubMed  CAS  Google Scholar 

  21. Redmon JB, Olson LK, Armstrong MB, Greene MJ, Robertson RP. Effects of tacrolimus (FK506) on human insulin gene expression, insulin mRNA levels, and insulin secretion in HIT-T15 cells. J Clin Invest 1996;98:2786–2793.

    Article  PubMed  CAS  Google Scholar 

  22. Drachenberg CB, Klassen DK, Weir MR, Wiland A, Fink JC, Bartlett ST, et al. Islet cell damage associated with tacrolimus and cyclosporine: morphological features in pancreas allograft biopsies and clinical correlation. Transplantation 1999;68:396–402.

    Article  PubMed  CAS  Google Scholar 

  23. Barrou Z, Seaquist ER, Robertson RP. Pancreas transplantation in diabetic humans normalizes hepatic glucose production during hypoglycemia. Diabetes 1994;43:661–666.

    Article  PubMed  CAS  Google Scholar 

  24. Kendall DM, Rooney DP, Smets YF, Salazar Bolding L, Robertson RP. Pancreas transplantation restores epinephrine response and symptom recognition during hypoglycemia in patients with longstanding type I diabetes and autonomic neuropathy. Diabetes 1997;46:249–257.

    Article  PubMed  CAS  Google Scholar 

  25. Bilous RW, Mauer SM, Sutherland DE, Najarian JS, Goetz FC, Steffes MW. The effects of pancreas transplantation on the glomerular structure of renal allografts in patients with insulin-dependent diabetes. N Engl J Med 1989;321:80–85.

    Article  PubMed  CAS  Google Scholar 

  26. Fioretto P, Steffes MW, Sutherland DE, Goetz FC, Mauer M. Reversal of lesions of diabetic nephropathy after pancreas transplantation. N Engl J Med 1998;339:69–75.

    Article  PubMed  CAS  Google Scholar 

  27. Navarro X, Kennedy WR, Loewenson RB, Sutherland DE. Influence of pancreas transplantation on cardiorespiratory reflexes, nerve conduction, and mortality in diabetes mellitus. Diabetes 1990;39:802–806.

    Article  PubMed  CAS  Google Scholar 

  28. Secchi A, Martinenghi S, Galardi G, Comi G, Canal N, and Pozza G. Effects of pancreatic transplantation on diabetic polyneuropathy. Transplant Proc 1991;23:1658–1659.

    PubMed  CAS  Google Scholar 

  29. Aridge D, Reese J, Niehoff M, Carney K, Lindsey L, Chun HS, et al. Effect of successful renal and segmental pancreatic transplantation on peripheral and autonomic neuropathy. Transplant Proc 1991;23:1670–1671.

    PubMed  CAS  Google Scholar 

  30. Caldara R, Sanseverino R, Lefrancois N, Martin X, Martinenghi S, Dubernard JM. Pancreas transplantation long-term results. Clin Transplant 1991;5:260–264.

    PubMed  CAS  Google Scholar 

  31. Gaber AO, Cardoso S, Pearson S, Abell T, Gaber L, Hathaway D, et al. Improvement in autonomic function following combined pancreas-kidney transplantation. Transplant Proc 1991;23:1660–1662.

    PubMed  CAS  Google Scholar 

  32. Allen RD, Al-Harbi IS, Morris JG, Clouston PD, O’Connell PJ, Chapman JR, et al. Diabetic neuropathy after pancreas transplantation: determinants of recovery. Transplantation 1997;63:830–838.

    Article  PubMed  CAS  Google Scholar 

  33. Navarro X, Sutherland DE, Kennedy WR. Long-term effects of pancreatic transplantation on diabetic neuropathy. Ann Neurol 1997;42:727–736.

    Article  PubMed  CAS  Google Scholar 

  34. Ramsay RC, Goetz FC, Sutherland DE, Mauer SM, Robison LL, Cantrill HL, et al. Progression of diabetic retinopathy after pancreas transplantation for insulin-dependent diabetes mellitus. N Engl J Med 1988;318:208–214.

    Article  PubMed  CAS  Google Scholar 

  35. Petersen MR, Vine AK. University of Michigan Pancreas Transplant Evaluation Committee. Progression of diabetic retinopathy after pancreas transplantation. Ophthalmology 1990;97:496–502.

    PubMed  CAS  Google Scholar 

  36. Scheider A, Meyer-Schwickerath E, Nusser J, Land W, Landgraf R. Diabetic retinopathy and pancreas transplantation: a 3-year follow-up. Diabetologia 1991;34(Suppl 1):S95–S99.

    Article  PubMed  Google Scholar 

  37. Zehrer CL, Gross CR. Comparison of quality of life between pancreas/kidney and kidney transplant recipients: 1-year follow-up. Transplant Proc 1994;26:508–509.

    PubMed  CAS  Google Scholar 

  38. Piehlmeier W, Bullinger M, Nusser J, Konig A, Illner WD, Abendroth D, et al. Quality of life in type 1 (insulin-dependent) diabetic patients prior to and after pancreas and kidney transplantation in relation to organ function. Diabetologia 1991;34(Suppl 1):S150–157.

    Article  PubMed  Google Scholar 

  39. Barrou B, Baldi A, Bitker MO, et al. Pregnancy after pancreas transplantation: report of four new cases and review of the literature. Transplant Proc 1995;27:3043–3044.

    PubMed  CAS  Google Scholar 

  40. Gruessner RW, Sutherland DE, Troppmann C, Benedetti E, Hakim N, Dunn DL, et al. The surgical risk of pancreas transplantation in the cyclosporine era: an overview. J Am Coll Surg 1997;185:128–144.

    Article  PubMed  CAS  Google Scholar 

  41. Douzdjian V, Ferrara D, Silvestri G. Treatment strategies for insulin-dependent diabetics with ESRD: a cost-effectiveness decision analysis model. Am J Kidney Dis 1998;31:794–802.

    Article  PubMed  CAS  Google Scholar 

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© 2003 Springer Science+Business Media New York

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Robertson, R.P. (2003). Pancreas Transplantation. In: Sperling, M.A. (eds) Type 1 Diabetes. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-310-1_29

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  • DOI: https://doi.org/10.1007/978-1-59259-310-1_29

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-258-2

  • Online ISBN: 978-1-59259-310-1

  • eBook Packages: Springer Book Archive

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