Experience of the National Hospital, Oslo, Norway

Abstract

A pancreas transplant programme was initiated in Norway in 1983 and so far (March 1988) a total of 53 diabetic patients have been treated with duct occluded segmental grafts. In 46 uremic patients the pancreas was transplanted simultaneously with a renal graft. The one year pancreas graft survival (insulin independent recipient) in this group was 66%. The 94% patient and 85% kidney graft survival rates over three years were identical with the results achieved in diabetic recipients of kidney grafts from living related donors. Of 7 non-uremic patients who received pancreatic grafts only, two have been insulin independent for more than one year. Next to rejection, late graft artery thrombosis was the most frequent known cause of graft loss in both groups. With the intention of increasing arterial blood flow and thus preventing thrombus formation, a new technique for graft revascularisation was developed, consisting of interposition of the graft artery between the common iliac and the inferior epigastric artery. This technique has been applied in 17 patients.