Indications and recipient selection

Indications and recipient selection

1. The goal of pancreas transplantation is to restore euglycemia and halt the progression of diabetic complications in patients who are unable to produce insulin owing to dysfunction of the beta cells of the pancreas.
2. Pancreas transplantation is most commonly performed as a simultaneous kidney-pancreas transplant or pancreas after kidney transplant for patients with ESRD and type 1 diabetes mellitus. Select patients with insulin-dependent type 2 diabetes mellitus may also be candidates for pancreas transplantation.
3. Pancreas transplant alone is generally reserved for patients with severe complications of type 1 diabetes mellitus including a history of frequent severe metabolic complications (eg, diabetic ketoacidosis) and failure of exogenous insulin therapy to prevent these complications.
4. Islet cell transplantation is an experimental therapy wherein islet cells from a deceased donor pancreas are harvested and then injected percutaneously into the portal vein.
5. In 2019, 143 pancreas transplants and 872 kidney-pancreas transplants were performed in the United States. The 5-year survival rates are estimated at greater than 88%.