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Solitary pancreas transplant not associated with improved survival for patients with diabetes

Patients with diabetes who received a solitary pancreas transplant appeared to have worse survival than patients on the transplant waiting list who received conventional therapy, according to a study in the December 3 issue of The Journal of the American Medical Association (JAMA).

According to background information in the article, pancreatic transplantation is a therapeutic option for patients with complicated diabetes mellitus. The American Diabetes Association supports the procedure for patients with diabetes who have had, or need, a kidney transplant. In the absence of kidney failure, pancreas transplantation may be considered for patients with diabetes and severe and frequent metabolic instability, i.e., episodes of very low blood glucose levels (hypoglycemia) or high blood glucose levels with buildup of blood acids (ketoacidosis).

According to the article, solitary pancreas transplantation (i.e., pancreas alone or pancreas-after-kidney) for diabetes mellitus remains controversial due to procedure-associated illness and/or death, toxicity of immunosuppression, expense, and unproven effects on the secondary complications of diabetes. Whether transplantation offers a survival advantage over conventional therapies for diabetes is unknown.

Jeffrey M. Venstrom, B.S., of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Md., and colleagues compared the survival of pancreas transplant recipients in patients with diabetes and preserved kidney function with that of similar patients listed for a pancreas transplant, since they would have conditions similar to those who underwent the transplant procedure.

The study was conducted using data from 124 transplant centers in the United States, with 11,572 patients with diabetes mellitus on the waiting list for pancreas transplantation (pancreas alone, pancreas-after-kidney, or simultaneous pa
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Contact: Joan Chamberlain
301-496-3583
JAMA and Archives Journals
2-Dec-2003


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