Surgical techniques for deceased donor pancreas transplantation

Sidharth Sharma, Kaylene Barrera, Rainer W.G. Gruessner

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The technical aspects of pancreas transplantation are both challenging and complex. From the first clinical pancreas transplant in 1966 by Kelly and Lillehei at the University of Minnesota over the first segmental living donor pancreas transplant in 1979 to robotically performed pancreas transplants in the current era, pancreas transplantation has evolved with many technical modifications over the past 50 years at a steep pace. While 1-year mortality rates in the first two decades were as high as 30% and 1-year graft failure rates as high as 80%, current 1-year mortality rates are < 5% and graft failure rates < 20% at 1 year. These tremendous improvements have been achieved due to the introduction of potent immunosuppressive drugs, in particular calcineurin inhibitors, and potent antimicrobial drugs, in particular acyclovir/gancyclovir and antifungal agents. But above all, improvements in surgical techniques, intraoperative management, and close posttransplant monitoring have contributed to excellent short- and long-term outcome. A whole-organ, deceased donor pancreas transplant with enteric and systemic venous drainage has become the gold standard of surgical techniques. Despite many advances in insulin therapy, a pancreas transplant remains the best treatment option for insulin-dependent patients to achieve the goal of insulin independence.

Original languageEnglish (US)
Title of host publicationTransplantation, Bioengineering, and Regeneration of the Endocrine Pancreas
Subtitle of host publicationVolume 1
PublisherElsevier
Pages149-167
Number of pages19
ISBN (Electronic)9780128148334
ISBN (Print)9780128148341
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Keywords

  • Bladder drainage
  • Enteric drainage
  • Pancreas transplant
  • Portal vein drainage
  • Robotic pancreas transplant
  • Systemic vein drainage

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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