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[PDF: Members Only] J.Jpn. Surg. Soc.. 121(2): 184-189, 2020
Feature topic
CURRENT STATUS AND PROSPECTS OF PANCREAS/ISLET TRANSPLANTATION
Patients with uncontrolled type 1 diabetes should be evaluated for the indications for pancreatic or islet transplantation. Pancreatic transplantation is covered by health insurance, while islet transplantation is performed in ongoing multicenter clinical trials. A total of 327 pancreas transplantations from brain-dead donors was performed from 2000 to 2017, including 267 simultaneous pancreas and kidney (SPK) transplantations, 43 pancreas transplantations after kidney transplantation, and 17 pancreatic transplantations alone. Patient survival rates at 1, 3, and 5 years posttransplantation were 96.4%, 96.0%, and 94.8%, respectively, and pancreatic graft survival rates at 1, 3, and 5 years posttransplantation were 86.3%, 80.2%, and 74.9%, respectively. On the other hand, islet transplantation started in 2012 in a multicenter clinical study, and the utilization of pancreata from brain-dead donors started in 2013. With the availability of pancreata from brain-dead donors, the success rate of islet isolation has improved and more islet transplants have been performed. From the viewpoint of improving the prognosis of patients on recipient waiting lists, SPK transplantation should be given priority. On the other hand, when islet transplantation is approved for coverage by health insurance, it may become the first choice for patients with type 1 diabetes without renal failure.
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