Cited by 256Pancreatic function and diabetesTransplantation: Methods and OutcomesOrgan Transplantation Techniques and Outcomes

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The current state of pancreas transplantation

Gruessner, Rainer W. G., Gruessner, Angelika C.·2013·Nature Reviews Endocrinology

DOI 10.1038/nrendo.2013.138

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Abstract

For many patients with type 1 diabetes mellitus and selected patients with type 2 diabetes mellitus, a successful pancreas transplant is the only definitive long-term treatment that both restores euglycaemia without the risk of severe hypoglycaemia and prevents, halts or reverses secondary complications. These benefits come at the cost of major surgery and lifelong immunosuppression. Nevertheless, pancreas transplants are safe and effective, with patient survival rates currently >95% at 1 year and >88% at 5 years; graft survival rates are almost 85% at 1 year and >60% at 5 years. The estimated half-life of a pancreas graft is now 7-14 years. The improvements in graft survival are attributable to considerable reductions in technical failures and in immunologic graft losses. Pancreas recipients have reduced mortality compared with waiting candidates or patients with diabetes mellitus who undergo a kidney transplant alone. Pancreas transplants should be more frequently offered to nonuraemic patients with brittle diabetes mellitus to prevent the development of secondary diabetic complications and to avoid the need for a kidney transplant. Although the results of islet transplantation have also improved, islet recipients rarely maintain long-term insulin independence despite the use of multiple organ donor pancreases. Pancreas transplants and islet transplants should be considered complementary, not mutually exclusive, procedures that are chosen on the basis of the individual patient's surgical risk.

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Holt, R. I. G., DeVries, J. H., Fischl, A. H., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, É., et al. (2021) · Diabetologia · doi:10.1007/s00125-021-05568-3 · Cited by 470

See all 256

Authors: Gruessner, R. W. G., & Gruessner, A. C.
Affiliations: University of Arizona (US)
Corresponding author: Gruessner, Rainer W. G.
ORCID: Gruessner, Rainer W. G.
Gruessner, Angelika C.
Venue: Nature Reviews Endocrinology
Publisher: Springer Science and Business Media LLC
Published: 2013-07-30
Volume: 9
Issue: 9
Pages: 555-562
ISSN: 1759-5029 (ISSN-L)
1759-5037
DOI: 10.1038/nrendo.2013.138
OpenAlex: W1997688914
Cited by: 256
References: 76
Citations by year: 2026: 5 · 2025: 8 · 2024: 13 · 2023: 26 · 2022: 15 · 2021: 19 · 2020: 20 · 2019: 25 · 2018: 21 · 2017: 13 · 2016: 37 · 2015: 39 · 2014: 14 · 2013: 1
Type: book review
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Endocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: University of Minnesota
University of Arizona
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
Keywords: pancreas transplantation, type 1 diabetes, type 2 diabetes, islet transplantation, graft survival, immunosuppression, diabetes complications, brittle diabetes, kidney transplantation, insulin independence
MeSH terms: Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Male, Pancreas Transplantation, Islets of Langerhans Transplantation, Treatment Outcome

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