Longnecker's Anesthesiology > Part 4. Managing Anesthesia Care > Section E. Specialty Areas of Anesthetic Practice > Chapter 58. Anesthesia for Kidney, Pancreas, or Other Organ Transplantation David S. Beebe, MD, and Kumar G. Belani, MBBS, MS

Pancreas and Islet Cell Transplantation

"In 1967, Kelly et al.⁴⁴ reported the first combined transplantation of the pancreas and duodenum along with a kidney in a human with diabetic nephropathy. Today, this procedure is commonplace for the surgical treatment of type 1 diabetes mellitus in patients with ESRD. Because renal failure often accompanies diabetes mellitus and although pancreas transplantation alone can be done, pancreas transplantation is most commonly performed (as mentioned in the discussion on kidney transplantation) simultaneously with a kidney transplant procedure or following kidney transplantation.^45,46 Thus, transplantation of the pancreas or islet cells⁴⁷ constitutes surgical treatment for patients with type 1 diabetes mellitus and now increasingly for those with type 2 diabetes mellitus (Fig. 58–2).^45,48 Cadaveric donors provide whole pancreas grafts and islet cells, whereas living donors provide distal segments for transplantation. Autologous islet cell transplantation is the treatment of choice for endocrine deficiency following total pancreatectomy.⁴⁹ The most recent published data (2005) indicate that more than 23,000 pancreas transplants from approximately 140 centers in the United States were reported to the International Pancreas Transplant Registry.⁴⁵ The majority (>17,000) were performed in the United States (Fig. 58–3). The majority of transplants are simultaneous pancreas and kidney transplants (78%), then pancreas after kidney transplants (16%), followed by pancreas transplants alone..."