Success and complications of pancreatic transplantation at one institution

Objective: The authors report the results and complications of the first 59 pancreas transplantation procedures performed at one institution. Summary Background Data: Pancreas transplantation is performed at relatively few centers. Results have improved in the past few years. Methods: A retrospective review was completed of the results and complications after pancreas transplantation at one institution. Pancreas transplantation was indicated for patients with insulin dependent diabetes mellitus and who were younger than 50 years of age. The results were divided into era I (March 1987-December 1992) and era II (January 1993-October 1995). Results: Fifty- nine transplants were performed since March 1987. There were 45 combined kidney/pancreas transplants and 13 pancreas transplants. Graft survival at 1 year was 57% for those in era I versus 79% in era II. Rejection occurred in 74% of the patients in era I and 48% in era II. Eighty five percent of all rejection episodes in both eras were steroid resistant and required antibody therapy. Complications were not different from eras I and II. Conclusions: Pancreas transplantation is a successful procedure with a number of significant complications. Rejection episodes are most often steroid resistant.