Perspectives

Pancreas and islet transplantation in diabetes. Who is eligible?

Perspectives

Pancreas and islet transplantation in diabetes. Who is eligible?

Heather Burns, Charmaine Cheung, Jenny E. Gunton

Figures

© john bavosi/spl
© john bavosi/spl

Abstract

Pancreas and islet transplantation offer recipients greatly improved quality of life and the possibility of a cure of diabetes. Both are associated with reduced mortality and diabetes-complications risks but they have very different suitability criteria. Suitable patients should be considered for assessment with consideration of the long-term burden of immunosuppression on the patient.

Key Points

  • Pancreas and islet transplants offer eligible patients with type 1 diabetes improved quality of life.
  • Whole pancreas transplantation in Australia is usually performed with a kidney transplant (simultaneous kidney-pancreas transplant; SKPT).
  • SKPT has a high long-term success rate and improves kidney-transplant outcomes.
  • Islet transplantation is a less invasive procedure suitable for select people with type 1 diabetes who have good renal function, and is very successful at ameliorating severe, recurrent hypoglycaemia.
  • Both forms of transplantation require long-term immunosuppression, and the potential side-effects of these must be considered for each patient.
  • If a patient is interested in having and may be suitable for a transplant, consider referring them for assessment.