Chapter 90 Pancreas Transplantation

Current World Health Organization estimates are that about 9% of the global population have diabetes. In certain diabetic patients without renal insufficiency, pancreas transplantation alone can be performed to avert life-threatening complications of hypoglycaemia and to prevent the progression of diabetic complications. Transplantation of the islets of Langerhans is an alternative to pancreas transplant alone for patients with hypoglycaemic unawareness. The indications for pancreas transplant can be split into those for patients with concomitant renal failure and those without. Once the indication for pancreas transplantation is satisfied the patient needs a comprehensive assessment of cardiovascular and surgical fitness. Pancreas organ retrieval is standardised in the UK and is carried out by dedicated abdominal organ retrieval teams. Static cold storage has remained the gold standard preservation method for the pancreas graft since the first transplantation was performed in 1966.

Multiple Choice Questions
Weblinks

Journal article

https://www.bmj.com/content/357/bmj.j1321/ (paid)

This is a comprehensive review of pancreas transplantation published in BMJ in 2017. It describes the current state of pancreas transplantation, gaps in knowledge and future studies needed to enable more patients to benefit from this treatment

Websites

https://www.odt.nhs.uk/transplantation/pancreas/

This is a link to the pancreas transplant page on the Organ Donation and Transplantation (ODT) section of the NHS Blood and Transplant website. It is aimed at healthcare professionals and provides access to all UK policies and guidance on the subject alongside information and updates from national advisory groups.

https://www.nhsbt.nhs.uk/organ-transplantation/pancreas/

This is a link to the pancreas transplant page of the NHS Blood and Transplant website that is aimed at patients and relatives. It provides an overview of what individuals should expect before and after transplant and gives information on ‘facts and figures’ as well as support and patient groups.

https://www.mayoclinic.org/tests-procedures/pancreas-transplant/about/pac-20384783/

The Mayo Clinic information page on pancreas transplantation. It provides clear and detailed information.

Video

https://www.youtube.com/watch?v=TpSyNCatRvI

A video created by surgeons at Houston Methodist in the USA. It shows the technique of preparing the pancreas for transplant on the back table and the surgical implant.

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