J.Jpn. Surg. Soc.. 124(2): 190-197, 2023

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Feature topic

CURRENT STATUS OF AND PROSPECTS FOR PANCREAS AND ISLET TRANSPLANTATION FOR DISORDERS OF GLUCOSE METABOLISM

Pancreas and islet transplantations are performed in a selected group of patients with insulin-dependent diabetes mellitus complicated by recurrent severe hypoglycemia even with strict insulin therapy or renal failure requiring kidney transplantation. Pancreas transplantation is often performed simultaneously with renal transplantation, and with advances in transplantation techniques and improvements in immunosuppressive therapy, the results have stabilized, establishing pancreas transplantation as a treatment that can improve the prognosis of patients with insulin-dependent diabetes mellitus. Islet transplantation, a minimally invasive cell transplantation technique, is a more advantageous transplantation treatment without the invasive surgery and perioperative complications that can be a drawback of pancreas transplantation. Although the results of islet transplantation were initially insufficient to establish it as a commonly accepted treatment, recent favorable clinical trials and clinical results have confirmed improved results. Islet transplantation has become a common medical procedure in many countries and is becoming established as a treatment option for patients with severe insulin-dependent diabetes mellitus. In Japan, islet transplantation has been covered by insurance starting in 2020, and patients are able to choose between pancreas transplantation and islet transplantation, which is expected to lead to new developments in the future.

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