Evolution of pancreas transplant surgery

ANZ J Surg. 2010 Jun;80(6):411-8. doi: 10.1111/j.1445-2197.2010.05309.x.

Abstract

Background: Type 1 diabetes mellitus is a chronic condition often leading to disabling complications including retinopathy, neuropathy and cardiovascular disease which can be modified by intensive treatment with insulin. Such treatment, however, is associated with a restrictive lifestyle and risk of hypoglycaemic morbidity and mortality.

Methods: This review examines the role of pancreas transplantation in patients with Type 1 diabetes mellitus.

Results: Pancreas transplantation is currently the only proven option to achieve long-term insulin independence, resulting in an improvement or stabilization of those diabetic related complications. The hazards of pancreas transplantation as a major operation are well known. Balancing the risks of a surgical procedure, with the benefits of restoring normoglycaemia remains an important task for the pancreas transplant surgeon. Pancreas transplantation is not an emergency operation to treat poorly managed and non-compliant patients with debilitating complications. It is a highly specialized procedure which has evolved both in terms of the surgical technique, patient selection and assessment.

Conclusion: Pancreas transplantation has emerged as the single most effective way to achieve normal glucose homeostasis in patients with Type 1 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / surgery*
  • Humans
  • Pancreas / blood supply
  • Pancreas / surgery
  • Pancreas Transplantation*
  • Pancreatectomy / methods
  • Patient Selection
  • Tissue and Organ Procurement

Substances

  • Blood Glucose