ABSTRACT
Pancreas transplantation has been used as therapy for type 1 diabetes mellitus for the last 20 or more years. It is the only therapy that successfully renders such patients insulin-independent and normoglycemic. However, successful transplantation requires subjects to be maintained on long-term immunosuppression, which increases their risk for infection and malignancy. Whether patients ultimately live longer and with less morbidity using life-long immunosuppression following pancreas transplantation than when using traditional insulin therapy is uncertain. Consequently, it is difficult for the practitioner to determine which patients would benefit most from pancreas transplantation. In this chapter, we will review the technique of pancreas and islet transplantation, discuss the risks and benefits of the procedure, and develop a Ust of indications and contraindications for this surgical therapy. At the end, clinicians will have a better understanding of the role pancreas transplantation plays in the treatment of their patients with type 1 diabetes.
