REVIEW – April 2016

Pancreas transplantation – treatment modality in complicated diabetes

Authors: Marko Murruste, Karri Kase

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Pancreas transplantation has become an important treatment modality for severely complicated diabetes in most developed countries. The main indication for it is diabetic nephropathy caused by type I diabetes, in which case the patients require kidney transplantation. Additional pancreas transplantation and hence elimination of diabetes will significantly improve the posttransplant quality of life of these patients, will prolong their life span and will stop or inhibit development of the secondary complications of diabetes.

In rare cases pancreas transplantation can be considered as an isolated procedure, e.g. in the case of unstable type I diabetes in presence of episodes of life-threatening hypoglycaemia.

In single cases pancreas transplantation is opted for, simultaneously with transplantation of other solid organs (liver, lung, small intestine), in patients with type I diabetes.

Regarding current surgical methods and immunosuppression of these patients, good function of the pancreas graft can be prognosticated for long term – for more than 10 years in over 50% of cases.

Since the current year year, pancreas transplantation is also available for Estonian patients. The expected annual demand for this operation is 5–10.