Pancreas transplant outcomes are now truly excellent. Even though there is an inherent TF rate for pancreas transplantation that will never be eliminated, it is much lower than even a decade ago. Anti-rejection management has evolved to the extent that rejection graft loss rates have been dramatically lowered. In all categories, SPK, PAK and PTA, pancreas 1 year GSRs of 80%-85% are achievable, while patient survival rates at 1 year were 95% for SPK and PAK and 98% for PTA.
While SPK transplants are still more frequent than solitary pancreas transplants, the latter continue to increase. This is particularly true for PAK, reflecting an emphasis on living donor kidney transplants in uremic diabetic patient to preempt the need for dialysis.
Variables that used to be important to GSRs, such as duct and vascular management, preservation times and other numerous variables, now have little impact. However, recipient age still matters even though the range is wide; there is less rejection in older recipients even if patient survival rates are not as high (expected) compared to younger recipients. More pancreas transplant recipients are classified as having type 2 diabetes than in previous years. At this time, outcomes are similar for type 1 and type 2, but further analyses are needed to determine if the two groups really do differ epidemiologically.
Predominance of pancreas transplantation in the US compared to non-US remains, although since reporting is not obligatory outside the US, the exact difference in transplant rates throughout the world is uncertain. For those pancreas transplants that are reported, outcomes are remarkably similar in and outside the US.
Previous page / Index
Return to: Medical School : Academic Health Center : myU : U of M Home
