PMID- 21150617
OWN - NLM
STAT- MEDLINE
DCOM- 20130625
LR  - 20181202
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 16
IP  - 1
DP  - 2011 Feb
TI  - Pancreas transplantation for type 2 diabetes mellitus.
PG  - 110-5
LID - 10.1097/MOT.0b013e3283424d1f [doi]
AB  - PURPOSE OF REVIEW: This review will provide evidence that selected patients with 
      type 2 diabetes mellitus (T2DM) may benefit from vascularized pancreas 
      transplantation (PTX). RECENT FINDINGS: Initial experience with simultaneous 
      pancreas-kidney transplantation (SPKT) in patients with T2DM and end-stage renal 
      disease (ESRD) suggested that augmentation of endogenous insulin production by 
      PTX in patients with C-peptide-positive, insulin-requiring diabetes resulted in 
      insulin independence, improved glucose counter-regulation, and enhanced quality 
      of life. A number of single-center retrospective studies have documented 
      equivalent outcomes in patients with either type 1 diabetes mellitus (T1DM) or 
      T2DM undergoing predominantly SPKT, although clearly a selection bias exists for 
      patients in the latter category. Selection criteria for SPKT in T2DM include 
      patients less than 55-60 years of age with a BMI less than 30-32 kg/m(2), 
      insulin-requiring for a minimum of 5 years with a total daily insulin requirement 
      less than 1 u/kg/day, a fasting C-peptide level less than 10 ng/ml, absence of 
      severe vascular disease or tobacco abuse, adequate cardiac function, and presence 
      of 'complicated' diabetes. Data from the International Pancreas Transplant 
      Registry show that up to 7% of SPKT recipients are classified as having T2DM and 
      that outcomes in these patients are comparable to those undergoing SPKT and 
      classified as having T1DM. SUMMARY: Consequently, characterization of the 'type' 
      of diabetes may be irrelevant and insulin-requiring diabetic patients with ESRD 
      should be evaluated for PTX based exclusively on their predicted ability to 
      tolerate the surgical procedure and requisite immunosuppression as well as comply 
      with a stringent posttransplant follow-up regimen.
FAU - Orlando, Giuseppe
AU  - Orlando G
AD  - Wake Forest Institute for Regenerative Medicine, Winston Salem, North Carolina 
      27106, USA.
FAU - Stratta, Robert J
AU  - Stratta RJ
FAU - Light, Jimmy
AU  - Light J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Organ Transplant
JT  - Current opinion in organ transplantation
JID - 9717388
SB  - IM
MH  - Diabetes Mellitus, Type 1/surgery
MH  - Diabetes Mellitus, Type 2/*surgery
MH  - Humans
MH  - Pancreas Transplantation/adverse effects/*methods
EDAT- 2010/12/15 06:00
MHDA- 2013/06/26 06:00
CRDT- 2010/12/15 06:00
PHST- 2010/12/15 06:00 [entrez]
PHST- 2010/12/15 06:00 [pubmed]
PHST- 2013/06/26 06:00 [medline]
AID - 10.1097/MOT.0b013e3283424d1f [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2011 Feb;16(1):110-5. doi: 
      10.1097/MOT.0b013e3283424d1f.