Pancreas and islet cell transplantation

Pancreas grafting is mainly performed in combination with kidney transplantation in uremic type 1 diabetic patients. According to the international patient registry, patient 1-year/10-year survival rates following simultaneous kidney/pancreas transplantation is 94-100/79%, while for kidneys it is 89-92/63% and for the pancreas 85-87/53%. The high success rate with long-lasting normalization of glucose metabolism leads to a stabilization and/or amelioration of secondary complications and to a significant reduction in mortality, which is much higher when compared to that of kidney graft recipients with a comparable risk profile. Pancreas transplantation alone in patients with good kidney function or after successful renal grafting (living-related donation) requires special criteria. Islet grafting involves only a minor surgical procedure, but the short- and long-term results are poor compared to pancreas grafting. Insulin independence is found in 44% at 1 year and in 13% of patients at 3 years following islet transplantation. However, partial success with a detectable C-peptide secretion, improved glucose metabolism and a reduction in hypoglycemic events was found more frequently.