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World J Transplant. 2019 Aug 26;9(4):81-93. doi: 10.5500/wjt.v9.i4.81.

Pancreatic transplantation: Brief review of the current evidence.

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1
Department of Nephrology, Sur Hospital, Sur 411, Oman.
2
Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, Liverpool L69 3GB, United Kingdom.
3
Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, Liverpool L69 3GB, United Kingdom. ahmed.halawa@sth.nhs.uk.

Abstract

Kidney transplantation is the treatment of choice for management of end-stage renal disease. However, in diabetic patients, the underlying metabolic disturbance will persist and even may get worse after isolated kidney transplantation. Pancreatic transplantation in humans was first introduced in 1966. The initial outcome was disappointing. However, this was changed after the improvement of surgical techniques together with better patient selection and the availability of potent and better-tolerated immune-suppression like cyclosporine and induction antibodies. Combined kidney and pancreas transplantation will not only solve the problem of organ failure, but it will also stabilise or even reverse the metabolic complications of diabetes. Combined kidney and pancreas transplantation have the best long term outcome in diabetic cases with renal failure. Nevertheless, at the cost of an initial increase in morbidity and risk of mortality. Other transplantation options include pancreas after kidney transplantation and islet cell transplantation. We aim by this work to explore various options which can be offered to a diabetic patient with advanced chronic kidney disease. Our work will provide a simplified, yet up-to-date information regarding the different management options for those diabetic chronic kidney failure patients.

KEYWORDS:

Combined kidney pancrease transplantation; Diabetes mellitus; Diabetic kidney disease; Renal transplantation

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

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