Can the pancreas be transplanted?

The pancreas can be transplanted. Pancreas transplantation is mainly used to treat insulin-dependent diabetes mellitus. However, when performing this transplantation operation, it is important to decide the treatment method based on the patient's condition.

1. Pancreas transplantation is mainly used to treat insulin-dependent diabetes mellitus , including pancreas transplantation using vascular anastomosis (referred to as pancreatic transplantation) and islet transplantation using pancreatic islets.

2. Pancreatic transplantation includes pancreaticoduodenal transplantation including duodenum , whole pancreas transplantation and pancreatic segment transplantation of different ranges. The pancreas may be transplanted alone or in combination with a kidney. In December 1966, four surgeons, Kelly, Lillehei, Merkel, and Idezuk, from the University of Minnesota Hospital performed the first pancreas-kidney transplant on two patients who were critically ill with diabetic renal failure, ushering in a new era of clinical pancreas transplantation. From 1966 to 1986, the International Pancreas Transplantation Registry received reports of 1,001 pancreas transplants in 932 diabetic patients. The overall one-year pancreatic function rate was 35% and the one-year survival rate of patients was 75%. The problems with pancreatic transplantation are rather complicated, and the initial transplant success rate was low, which affected the widespread application of this therapy. Since the advent and widespread application of cyclosporine A (CsA) in 1983 and the advancement of transplantation technology, pancreatic transplantation has developed rapidly. As of June 15, 1990, a total of 2,639 pancreatic transplants had been performed worldwide, with a one-year survival rate of 56% for transplanted pancreas and an approximately 85% one-year survival rate for patients after surgery. By the end of 1997, 7,559 combined pancreas-kidney transplants and 2,260 pancreas-only transplants had been performed worldwide, and the transplant results had reached the level of other major organ transplants.

3. Currently, in some organ transplant centers , the early results of pancreas transplantation are encouraging. Currently, Sutherland Hospital at the University of Minnesota in the United States has the most extensive experience in pancreas transplantation. From 1978 to 1986, a total of 161 pancreas transplants were performed. Before 1983, the one-year function rate of 62 transplanted pancreases was 21%. Since 1983, with the use of triple anti-immunotherapy with CsA, azathioprine and prednisone, and the use of preserved donor pancreases, the one-year survival rate of 99 pancreas transplant patients was 88%, and the one-year function rate of the transplanted pancreas was 40%. From 1976 to 1986, LaRocca in Lyon, France, performed a total of 76 pancreas transplants on 73 patients with insulin-dependent diabetes mellitus, of which 64 underwent combined pancreas and kidney transplants. Under triple immunosuppressive therapy with CsA, prednisone, and azathioprine, the one-year survival rates of the patient, pancreas, and kidney were 86%, 77%, and 80%, respectively; in the 10 patients who underwent pancreas and duodenal transplants, the 21-month survival rates of the patient and pancreas were 89% and 80%, respectively. Currently, pancreas transplantation has passed the clinical trial stage and entered the clinical application stage. Previous pancreatic transplants mostly drained the pancreatic duct into the bladder, but this non-physiological reconstruction surgery itself has certain disadvantages. Therefore, there is a gradual trend towards anastomosis of the pancreatic duct and the intestine to reconstruct the physiological channel for pancreatic juice discharge.