Pancreas and Islet Transplantation


COD: 2004_01_001-8 Categorie: ,

Prof. Nadey Hakim, V. Papalois, President Elect International College of Surgeons, St. Mary’s Hospital London

Ann. Ital. Chir., LXXV, 1, 2004

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The syndrome of type I insulin-dependent diabetes mellitus (IDDM) includes not only abnormal glucose metabolism
but also specific microvascular complications such as retinopathy, nephropathy and neuropathy. Diabetes mellitus is currently the leading cause of kidney failure and blindness in adults, the number one disease cause of amputations and impotence, and one of the leading chronic diseases of childhood associated with poor quality of life.
The aim of pancreas and islet transplantation is to establish the same status of glucose control that is provided by endogenous secretion of insulin from a healthy native pancreas in order to improve the quality of life and
ameliorate secondary diabetic complications in patients with IDDM.
The first pancreas transplant in a human was performed by Kelly and Lillehei on 16 December 1966 at the
University of Minnesota (1).
Islet transplantation is, theoretically, an ideal solution for patients with IDDM since it is not a major procedure,
can be performed radiologically and can be repeated several times without any major discomfort to the patient.
Islet transplantation in humans has been performed systematically since 1974 and, as with pancreas transplantation,
the University of Minnesota pioneered the field (2). However, despite tedious experimental and clinical efforts over the past 25 years, long term and consistent nsulin independence has not yet been achieved.


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