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World J Diabetes. Dec 15, 2014; 5(6): 951-961
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.951
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.951
Pancreas transplantation: The Wake Forest experience in the new millennium
Jeffrey Rogers, Alan C Farney, Giuseppe Orlando, Michael D Gautreaux, Robert J Stratta, Department of General Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC 27157, United States
Samy S Iskandar, Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, United States
William Doares, Scott Kaczmorski, Department of Pharmacy, Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, United States
Amber Reeves-Daniel, Amudha Palanisamy, Department of Internal Medicine (Nephrology), Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, United States
Author contributions: Rogers J, Farney AC, Orlando G and Stratta RJ contributed equally to this work, including study design, data analysis and writing the manuscript; Iskandar SS, Doares W, Gautreaux MD, Kaczmorski S, Reeves-Daniel A and Palanisamy A provided critical review and revisions of the manuscript.
Correspondence to: Robert J Stratta, MD, Department of General Surgery, Wake Forest Baptist Medical Center, Medical Center Blvd., Winston Salem, NC 27157, United States. rstratta@wakehealth.edu
Telephone: +1-336-7160548 Fax: +1-336-7135055
Received: April 23, 2014
Revised: October 31, 2014
Accepted: November 7, 2014
Published online: December 15, 2014
Revised: October 31, 2014
Accepted: November 7, 2014
Published online: December 15, 2014
Core Tip
Core tip: Vascularized pancreas transplantation is able to establish a chronic insulin-free state characterized by normoglycemia. In selected recipients with insulin-requiring diabetes, simultaneous kidney-pancreas transplantation has become acknowledged as a favored alternative to kidney alone transplantation because of more intense glucose control, enhanced quality of life and improved long-term survival. The evolution in surgical technique, current patient management strategies, and biopsy directed immunosuppression have resulted in excellent outcomes, even in populations previously considered high risk, such as African-American recipients, patients with a “type 2 diabetes” phenotype and solitary pancreas transplants recipients.