Pancreas transplantation

(Redirected from Pancreas transplant)
Jump to navigation Jump to search

Template:Interventions infobox

WikiDoc Resources for Pancreas transplantation

Articles

Most recent articles on Pancreas transplantation

Most cited articles on Pancreas transplantation

Review articles on Pancreas transplantation

Articles on Pancreas transplantation in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Pancreas transplantation

Images of Pancreas transplantation

Photos of Pancreas transplantation

Podcasts & MP3s on Pancreas transplantation

Videos on Pancreas transplantation

Evidence Based Medicine

Cochrane Collaboration on Pancreas transplantation

Bandolier on Pancreas transplantation

TRIP on Pancreas transplantation

Clinical Trials

Ongoing Trials on Pancreas transplantation at Clinical Trials.gov

Trial results on Pancreas transplantation

Clinical Trials on Pancreas transplantation at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Pancreas transplantation

NICE Guidance on Pancreas transplantation

NHS PRODIGY Guidance

FDA on Pancreas transplantation

CDC on Pancreas transplantation

Books

Books on Pancreas transplantation

News

Pancreas transplantation in the news

Be alerted to news on Pancreas transplantation

News trends on Pancreas transplantation

Commentary

Blogs on Pancreas transplantation

Definitions

Definitions of Pancreas transplantation

Patient Resources / Community

Patient resources on Pancreas transplantation

Discussion groups on Pancreas transplantation

Patient Handouts on Pancreas transplantation

Directions to Hospitals Treating Pancreas transplantation

Risk calculators and risk factors for Pancreas transplantation

Healthcare Provider Resources

Symptoms of Pancreas transplantation

Causes & Risk Factors for Pancreas transplantation

Diagnostic studies for Pancreas transplantation

Treatment of Pancreas transplantation

Continuing Medical Education (CME)

CME Programs on Pancreas transplantation

International

Pancreas transplantation en Espanol

Pancreas transplantation en Francais

Business

Pancreas transplantation in the Marketplace

Patents on Pancreas transplantation

Experimental / Informatics

List of terms related to Pancreas transplantation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who has diabetes. Because the pancreas performs functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas attached in a different location. In the event of rejection of the new pancreas, the recipient could not survive without the native pancreas still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor. [1] Whole pancreas transplants from living donors are not possible, again because the pancreas is a necessary organ for digestion. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes who have severe complications.

Types

There are three main types of pancreas transplantation:

  • Simultaneous pancreas-kidney transplant (SPK), when the pancreas and kidney are transplanted simultaneously from the same deceased donor.
  • Pancreas-after-kidney transplant (PAK), when a cadaveric, or deceased, donor pancreas transplant is performed after a previous, and different, living or deceased donor kidney transplant.
  • Pancreas transplant alone, for the patient with type 1 diabetes who usually has severe, frequent hypoglycemia, but adequate kidney function.

CT image demonstrates a right lower quadrant pancreas transplant

Indications

In most cases, pancreas transplantation is performed on individuals with type 1 diabetes with end-stage renal disease The majority of pancreas transplantations (>90%) are simultaneous pancreas-kidney transplantions.[2]

Preservation until implantation

The donor's blood in the pancreatic tissue will be replaced by an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft pancreatic tissue is implanted.

Complications

Complications immediately after surgery include rejection, thrombosis, pancreatitis and infection.

Prognosis

The prognosis after pancreas transplantation is very good. Over the recent years, long-term success has improved and risks have decreased. One year after transplantation more than 95% of all patients are still alive and 80-85% of all pancreases are still functional. After transplantation patients need lifelong immunosuppression. Immunosuppression increases the risk for a number of different kinds of infection[3] and cancer.

History

The first pancreas transplantation was performed in 1966, three years after the first kidney transplantation.[4] A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantation, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

References

  1. [1]
  2. Gruessner AC, Sutherland DE (2005). "Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004". Clin Transplant. 19 (4): 433–55. PMID 16008587.
  3. Fishman JA, Rubin RH (1998). "Infection in organ-transplant recipients". N Engl J Med. 338 (24): 1741–51. PMID 9624195. Full text
  4. Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC (1967). "Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy". Surgery. 61 (6): 827–37. PMID 5338113.

External links

Template:Organ transplantation Template:Digestive system surgical procedures

Template:WH Template:WikiDoc Sources