Innovations in pancreas transplantation.

Pancreas transplantation is currently the curative treatment for type I diabetes mellitus. It aims at providing physiological insulin replacement therapy in type 1 diabetes mellitus. The goal is thereby also to prevent secondary complications of diabetes. Long term control of glucose metabolism has only been achieved by pancreas transplantation. As a result of improvements in the surgical techniques and the efficacy of immunosuppression, the patient and graft survival rates have improved dramatically over the last 2 decades. As a result, pancreas transplantation, as part of simultaneous pancreas and kidney transplantation, pancreas after kidney transplantation, and exceptionally pancreas transplantation alone, became the standard therapeutic option for patients with type I diabetes mellitus with end-stage renal disease. In this article we review the pancreas transplantation methods, indications, techniques, and the short as well as the long outcomes of treatment.