“PUSHING THE ENVELOPE”: PANCREAS TRANSPLANTATION!!

In our country we have a wide Diabetic population including Type 1 (Juvenile Diabetes) and Type 2 (Maturity onset Diabetes). There is an increased demand for Insulin independence and a drive to avoid the complications of diabetes like Hypoglycemic unawareness, Diabetic Nephropathy, Diabetic Neuropathy, etc

Pancreas

On December 17, 1966 the first successful Pancreas Transplantation was done in a 16-year-old patient for Type 1 Diabetes Mellitus. The patient achieved insulin independence and that ignited the light for increased research. This led to an increased enthusiasm for this procedure. However, in the initial 70’s the interest dwindled and pancreas transplant did not gain acceptance like the kidney and liver transplantation due to increased complications, for over a decade! However, with further research and technical refinements and the introduction of more potent immunosuppressive medications (first cyclosporine and then tacrolimus) allowed for better outcomes after pancreas transplanta­tion!

pancreas-transplantation

Throughout the 80s and 90s, the number of pancreas transplants performed increased dramatically in the west. It is now gaining wide acceptance in the eastern countries and is being considered as a treatment option in our country too.

Isolated Pancreas transplant is done for Type1 Diabetes where the kidney has not been affected. Simultaneous Kidney and Pancreas transplant is done when the kidney has failed due to diabetic nephropathy.

The advantages seen after pancreas transplant are many, like achieving normal blood glucose control by the transplanted pancreas, which also protects the transplanted kidney (when a simultaneous kidney pancreas transplant is done) from recurrent diabetic nephropathy and reverses the complications like diabetic neuropathy etc., and is beneficial from an overall quality-of-life perspective!

About the Author

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Dr. Gursharan Singh, Head of the Department & senior consultant in digestive disease and multi organ transplantation in Coimbatore Kidney Centre and Speciality Hospitals.

You can get in touch with him at singhdrgursharan@gmail.com

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