Whole organ transplantation

Abstract

Pancreas transplantation, particularly in patients with type 1 diabetes, has been shown to be an effective intervention to restore insulin production and improve glycemic control, especially in those with diabetes complicated by kidney failure. This therapeutic approach can be classified into two main modalities: isolated pancreas transplantation and combined pancreas-kidney transplantation. The choice between these procedures is based on the presence of associated complications and the overall evaluation of the patient's condition.

Isolated pancreas transplant is indicated for patients with type 1 diabetes who do not have kidney failure. However, in those patients with chronic renal failure, combined pancreas-kidney transplantation becomes the preferred option, simultaneously addressing renal dysfunction and restoring endocrine function of the pancreas.

One of the main goals of pancreas transplantation is to achieve remission of diabetes, evidenced by restoration of normoglycemia and reduction of severe hypoglycemia. In the long term, pancreas transplants have graft survival rates ranging from 50% to 70% at 10 years, with a clinical success rate that varies depending on donor quality, immunological compatibility, and regimen adherence. immunosuppressant.

The main postoperative challenge is the management of immunosuppression to prevent graft rejection. Current immunosuppression regimens, which combine calcineurin inhibitors , antimetabolites , and steroids, have improved in terms of efficacy and side effect profile, but still carry significant risks, including opportunistic infections and tumors. In summary, pancreas transplant remains a valuable option for certain patients with type 1 diabetes, particularly those with severe complications. The combination of advances in surgical technique, immunosuppression and continued research in graft biology proClear.