Pancreatic Transplantation

The first pancreas transplant was performed in 1966 by Lillehei and Kelly at the University of Minnesota (1). Today, over 50 000 pancreas transplants have been performed globally and transplant is considered the treatment of choice for patients with type 1 diabetes mellitus (T1DM) with hypoglycaemic unawareness. Improvements in patient management has resulted in the expanding indications for both simultaneous pancreas kidney and isolated pancreas transplantation. However, the pancreas remains one of the most challenging organs to successfully transplant and a constant assessment of risks of surgery and immunosuppression needs to be made and weighed against the clinical benefit associated with the long-term tight glycaemic control offered by pancreas transplantation. With an estimated 15% of healthcare costs in the West being diabetes-related and the healthcare costs of a typical patient with T1DM being over $52 000 by the age of 40, pancreas transplantation remains both of significant clinical and economic importance (2).