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Pancreas Transplantation: Small-Center Experience in Type 1 Diabetes Mellitus in a High-Incidence Region.

Abstract：

BACKGROUND:Pancreas transplantation (PT) is the best option of care for patients with type I diabetes mellitus (T1DM). METHODS:From July 2005 to September 2014, we performed 27 PT from deceased donors (24 simultaneous pancreas-kidney transplantations [SPKT] and 3 pancreas transplantations alone) in a region with a high incidence of T1DM. RESULTS:Enteric drainage and systemic venous derivation were accomplished for all PT. Cold and warm ischemia times were 291 ± 70 minutes and 32 ± 9 minutes, respectively. The rate of early re-operations was 33%, mainly because of bleeding occurrence. Mean donor age was 31 ± 11 years; all patients had ABO compatibility and negative cross-match. With a mean follow-up time of 2.3 years, no death was registered. Graft survival of PT was 96.7%, with 1 graft loss in the SPKT group (3.7%) after acute rejection. Nine patients were submitted successfully to re-operation for no life-threatening complications within 30 post-operative days. No early or late episode of vascular thrombosis, pancreatitis, or pancreatic fistula was observed. All patients with a functioning graft had excellent metabolic control, with mean glycosylated hemoglobin level at last follow-up of 5.5% and median fasting glucose level of 95 ± 13 mg/dL, comparable to that in the non-diabetic population. CONCLUSIONS:In our experience, PT is an excellent therapeutic solution for patients with T1DM. Despite fewer than 5 PT performed per year, graft and patient outcomes were similar to those in high-volume centers.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Tondolo V,Manunza R,Pellegrino RA,Zamboni F

doi

10.1016/j.transproceed.2014.11.070

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

2169-72

issue

7

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(15)00636-3

journal_volume

47

pub_type

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