| Popis: |
A successful pancreas transplant is the only treatment option for diabetic patients to provide long-term insulin independence and normoglycemic control. Since the first pancreas transplant in 1966, patient and graft survival rates have significantly improved. According to the International Pancreas Transplant Registry, 5159 primary deceased donor pancreas transplants were performed between 2011 and 2016: 4342 (84%) simultaneous pancreas and kidney (SPK) transplants, 399 (8%) pancreas after kidney (PAK) transplants, and 418 (8%) pancreas transplants alone (PTA). A 1-year (3-year) SPK patient survival reached 98% (95%), PAK 97% (93%), and PTA 98% (96%). The most influential risk factor for patient death in all the three categories was a failed graft. SPK pancreas graft function improved to 90% at 1-year and 83% at 3-year posttransplant, to 87% and 74% for PAK, and to 84% and 71% for PTA. The difference in outcome between SPK and solitary transplants (PAK and PTA) is still significant but the gap is narrowing. Pancreas transplantation is a safe procedure with excellent outcome and should be more actively promoted for patients with brittle diabetes and in the absence of advanced secondary diabetic complications. |
