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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 2002 December;54(4):213-26

language: English

Simultaneous pancreas-kidney and pancreas transplantation

Becker B. N. 1, Becker Y. T. 2, Odorico J. S. 2, Pirsch J. D. 2, Sollinger H. W. 2

1 Division of Nephrology, Department of Medicine and 2 Division of Transplantation Department of Surgery, University of Wisconsin Madison, WI, USA


The ­best avail­able meth­od cur­rent­ly for achiev­ing ­steady nor­mog­ly­ce­mia in indi­vid­u­als ­with ­type 1 dia­betes mel­lit­us (DM) is replac­ing the pan­cre­as, e.g. ­whole pan­cre­as trans­plan­ta­tion. Pan­creat­ic trans­plan­ta­tion, as ­either simul­ta­ne­ous pan­cre­as-kid­ney (SPK) or sol­i­tary pan­cre­as trans­plan­ta­tion ­alone (PTA), has ­moved ­beyond sim­ple meta­bol­ic or qual­ity-of-­life ­goals. It is now an effec­tive treat­ment to ­reverse or min­i­mize meta­bol­ic abnor­mal­ities and com­pli­ca­tions of ­type 1 DM as ­well as poten­tial­ly ­extend the ­life ­span of ­those afflict­ed by ­type 1 DM and its ­many co-mor­bid com­pli­ca­tions. Can­di­dates for SPK and PTA trans­plan­ta­tion ­need to ­meet var­i­ous cri­te­ria ­even to under­go the trans­plant pro­ce­dure and ­receive a pan­creat­ic allo­graft ­that is ­deemed suit­able. SPK and PTA recip­ients, ­though ­free ­from insu­lin use, ­still may encoun­ter com­mon ­post-trans­plant med­i­cal com­pli­ca­tions, e.g. car­di­o­vas­cu­lar dis­ease, ­high ­blood pres­sure, as ­well as com­pli­ca­tions ­unique to SPK and PTA trans­plan­ta­tion. The advan­tag­es of PTA and SPK trans­plan­ta­tion are frank­ly now ­more obvi­ous as improve­ments in sur­gi­cal tech­nique and new immu­no­sup­pres­sion ­have ­made an increas­ing num­ber of PTA and SPK trans­plants ­viable and func­tion­al ­long-­term. The ­idea of pan­cre­as trans­plan­ta­tion can be tout­ed as a ther­a­peu­tic ­advance for ­type 1 DM. It can ­improve sur­vi­val and lim­it ­many dia­bet­ic-relat­ed com­pli­ca­tions, ­while improv­ing qual­ity of ­life, espe­cial­ly in ­those indi­vid­u­als ­also afflict­ed ­with dia­bet­ic-relat­ed kid­ney dis­ease.

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