J.Jpn. Surg. Soc.. 97(11): 984-989, 1996

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Feature topic

PANCREAS AND ISLET TRANSPLANTATIONS

Pancreas transplantation has been established as a treatment option for type I diabets mellitus with one-year patients survival rate of 91％ and one-year graft survival rate of 71％. Simultaneous pancreas andkindey transplantation with the bladder-drainage technique is most frequently performed. The bladder drainage technique makes amylase activity measurement in the urine as well as urine cytology possible, which facilitate a diagnosis of acute rejection. Combination treatment with cyclosporine, azatioprine, steroid and anti-lymphocyte globulin is usually employed for immunosuppression. In addition, FK506 in now available and expected to contribute to better graft survival. In contrast, islet transplantation has not yet achieved satisfactory results. Although a large number of islets can now be obtained from one pancreas, they are not sufficient for stabilizing a diabetic condition and multiple donors are stillrequired. Xeno-transplantation may resolve the problem. Both pancreas and islet transplantation will achieve better results with further advance of transplant techniques including immunosuppressive treatment and diagnostic methods for acute rejection.

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