Excerpt from Clinical Transplants 2012
Long -Term Pancreas Allograft Survival in Simultaneous Pancreas - Kidney Transplantation
by Era Kayo Waki, Yasuhiko Sugawara, Norihiro Kokudo, and Takashi Kadowaki Terasaki Foundation Laboratory, The University of Tokyo Hospital, Japan Corresponding
Pancreas transplantation is an acceptable therapeutic alternative to continued insulin therapy for diabetic patients (1). Initially, the procedure was not well accepted because of its high 1 -year acute rejection rates before 1994. Introduction of tacrolimus use in 1994 increased acceptance of pancreas transplants, resulting in more than 1,000 such procedures per year after 1995 — this acceptance encouraged by the promising outcomes of 500 simultaneous pancreas- kidney (SPK) transplants in 1998 (2, 3). The successful procedures have been shown to control the diabetic glycemic state and to improve the quality of life of patients with diabetes (4, 5). Reductions in rates of technical failure and early acute rejection have efficiently decreased early graft loss and have contributed to overall prolonged SPK transplant survival (6). Nevertheless, the significant beneficial effects of these technical and immunosuppressive improvements on chronic graft loss have not been translated into improved long- term —five year — pancreas graft survival (7).