Insulin-independence for > 10 years in 32 pancreas transplant recipients from an historical era

Abstract

Until microencapsulation of islets or β-cells or genetically engineered insulin-producing cells are in hand, the best option for preventing microvascular complications in type 1 diabetes is a allogeneic pancreas transplant. True, the surgery is difficult mandating long hospital stays. Also, when compared with a kidney transplant alone, both morbidity and mortality are greater in recipients of a combined pancreas and kidney transplant. Najarian reviewed his extraordinary experience with 867 pancreas transplants performed since July 1966. In this report, the 20 pancreas recipients transplanted between 1978 and 1986 who were alive with a functioning graft 10 to 17 years posttransplant were analyzed. By means of a mail questionnaire, responses on life quality were obtained from 14 survivors of whom all 14 preferred their sometimes tenuous life with a pancreas graft to that of medical diabetes management. Indeed, a remarkable 13 of 14 respondents thought that they would now be dead had they not received a pancreas transplant. Our limited, and thus far, short term observation of pancreas recipients confirms such broad patient acceptance. Physicians must deliver what is available today while eyeing a better future. Pancreas transplants though difficult, expensive, and stressful are nevertheless the preferred therapeutic option for all those with type 1 diabetes who are younger than age 45.