Success and complications of pancreatic transplantation at one institution.

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OBJECTIVE: The authors report the results and complications of the first 59 pancreas transplantation procedures performed at one institution. SUMMARY BACKGROUND DATA: Pancreas transplantation is performed at relatively few centers. Results have improved in the past few years. METHODS: A retrospective review was completed of the results and complications after pancreas transplantation at one institution. Pancreas transplantation was indicated for patients with insulin-dependent diabetes mellitus and who were younger than 50 years of age. The results were divided into era I (March 1987-December 1992) and era II (January 1993-October 1995). RESULTS: Fifty-nine transplants were performed since March 1987. There were 45 combined kidney/pancreas transplants and 13 pancreas transplants. Graft survival at 1 year was 57% for those in era I versus 79% in era II. Rejection occurred in 74% of the patients in era I and 48% in era II. Eighty-five percent of all rejection episodes in both eras were steroid resistant and required antibody therapy. Complications were not different from eras I and II. CONCLUSIONS: Pancreas transplantation is a successful procedure with a number of significant complications. Rejection episodes are most often steroid resistant.

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