Intervention: Pancreas transplantation
ICD-10 code:
ICD-9 code:	52.8
MeSH	D016035
Other codes:

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A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who usually has diabetes. Because the pancreas is a vital organ, performing functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas is attached in a different location. In the event of rejection of the new pancreas which would quickly cause life-threatening diabetes, the recipient could not survive without the native pancreas still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor. ^[1] At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes, who have severe complications that are usually of a renal nature. Patients with pancreatic cancer are not eligible for valuable pancreatic transplantations, since the condition has a very high mortality rate and the disease, being highly malignant, could and probably would soon return.

Contents 1 Types 2 Indications 3 Preservation until implantation 4 Complications 5 Prognosis 6 History 7 References 8 External links

[edit] Types

There are three main types of pancreas transplantation:

• Simultaneous pancreas-kidney transplant (SPK), when the pancreas and kidney are transplanted simultaneously from the same deceased donor.
• Pancreas-after-kidney transplant (PAK), when a cadaveric, or deceased, donor pancreas transplant is performed after a previous, and different, living or deceased donor kidney transplant.
• Pancreas transplant alone, for the patient with type 1 diabetes who usually has severe, frequent hypoglycemia, but adequate kidney function.

[edit] Indications

In most cases, pancreas transplantation is performed on individuals with type 1 diabetes with end-stage renal disease The majority of pancreas transplantations (>90%) are simultaneous pancreas-kidney transplantions.^[2]

[edit] Preservation until implantation

Standard practice is to replace the donor's blood in the pancreatic tissue with an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft pancreatic tissue is implanted.

[edit] Complications

Complications immediately after surgery include rejection, thrombosis, pancreatitis and infection.

[edit] Prognosis

The prognosis after pancreas transplantation is very good. Over the recent years, long-term success has improved and risks have decreased. One year after transplantation more than 95% of all patients are still alive and 80-85% of all pancreases are still functional. After transplantation patients need lifelong immunosuppression. Immunosuppression increases the risk for a number of different kinds of infection^[3] and cancer.

[edit] History

The first pancreas transplantation was performed in 1966 by the team of Dr. Kelly, Dr. Lillehei, Dr.Merkel, Dr.Idezuki Y, & Dr. Goetz, three years after the first kidney transplantation.^[4] A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantation, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

[edit] References

• Larsen JL (2004). "Pancreas transplantation: indications and consequences". Endocr Rev 25 (6): 919–46. doi:10.1210/er.2002-0036. PMID 15583023.  Full text
• International Pancreas and Islet Transplant Association

[edit] External links

• Diabetes Institute for Immunology and Transplantation
• International Pancreas and Islet Transplant Association

v • d • e Organ transplantation Types Autotransplantation · Allotransplantation · Xenotransplantation (Organ xenotransplantation) · Alloplant Organs and tissues Bone · Bone marrow · Corneal · Face · Hand · Head · Heart · Heart-lung · Kidney · Liver · Lung · Pancreas · Penis · Skin · Spleen · Uterus Related topics Biomedical tissue · Cellular memory · Edmonton protocol · Eye bank · Graft-versus-host disease · Immunosuppressive drugs · Islet cell transplantation · Implants · Living donor liver transplantation · Lung allocation score · Machine perfusion · Medical grafting · Non-heart beating donation · Organ donation · Post-transplant lymphoproliferative disorder · Repugnant market · Total body irradiation · Transplant rejection · Transplantation medicine Organizations Halachic Organ Donor Society · Human Tissue Authority · National Marrow Donor Program · United Network for Organ Sharing · DKMS Americas People Christiaan Barnard · Michael Woodruff · Alexis Carrel · Norman Shumway · Jean-Michel Dubernard · List of notable organ transplant donors and recipients

v • d • e Digestive system surgical and other procedures (ICD-9-CM V3 42-54) Digestive tract Upper GI tract SGs/Esophagus Sialography · Esophagectomy Stomach Gastrostomy (Percutaneous endoscopic gastrostomy) · Gastrectomy (Billroth I, Billroth II, Roux-en-Y) · Bariatric surgery (Gastric bypass surgery, Adjustable gastric band, Sleeve gastrectomy, Vertical banded gastroplasty surgery) · Gastroenterostomy · Hill repair · Nissen fundoplication · Gastropexy Imaging Endoscopy: Esophagogastroduodenoscopy Upper gastrointestinal series Lower GI tract Small bowel Bariatric surgery (Duodenal switch, Jejunoileal bypass) · Jejunostomy · Ileostomy · Partial ileal bypass surgery Large bowel Colectomy · Colostomy · Appendicectomy · Hartmann's operation Rectum Lower anterior resection · Abdominoperineal resection Anus Anal sphincterotomy · Lateral internal sphincterotomy Imaging Endoscopy: Colonoscopy (Virtual) · Proctoscopy · Sigmoidoscopy · Enteroscopy · Capsule endoscopy Transrectal ultrasonography · Enteroclysis · Small bowel follow-through · Abdominal ultrasonography · Lower gastrointestinal series Accessory Liver Hepatectomy · Liver transplantation · Artificial extracorporeal liver support (Liver dialysis, Bioartificial liver devices) Gallbladder, bile duct Cholangiography (Endoscopic retrograde cholangiopancreatography, Percutaneous transhepatic cholangiography, Magnetic resonance cholangiopancreatography) · Cholecystectomy · Cholecystography · HIDA scan Pancreas Pancreatectomy · Pancreaticoduodenectomy · Pancreas transplantation · Puestow procedure · Frey's procedure Abdominopelvic Peritoneum Paracentesis · Intraperitoneal injection Hernia Herniorrhaphy · MacEwen's operation Other Laparotomy digestive system navs: anat of tract,glands,perit,diaphragm/physio/dev, noncongen/congen/congen of d+w/neoplasia, symptoms+signs/eponymous, proc