Allogeneic segmental pancreas transplantation in diabetic dogs with and without occlusion of the pancreatic duct

Currently the rate of complications in segmental pancreas transplantation is very high. Reasons for this come from technical failures and from the site of immunology. To prove the cause of technical complications, several methods were used for the allogeneic segmental pancreas transplantation in diabetic dogs. To influence the exocrine pancreas secretion in grafts, we applied the intraductal injection of Ethibloc and Neoprene and the intraperitoneal drainage. By all these approaches it was possible to ameliorate an experimental diabetes in the recipients. Clearly better results were achieved in the Ethibloc-injected and open-duct grafts. The longest function time was about 6 months. Main complications, especially in the Neoprene-injected group, were venous thrombosis, pancreatitis and graft rejection.     

Current status of pancreas transplantation.

Pancreas transplantation for the treatment of diabetes mellitus is being done with increasing frequency. Refined operative techniques, an improved immunosuppression regimen, and an earlier recognition of rejection have led to dramatic increases in both graft and patient survival rates. Preliminary data suggest that a functioning pancreatic allograft may arrest or reverse most of the complications of diabetes, although the effects on retinopathy remain controversial. Patients also acquire a strong sense of well-being after successful pancreas transplantation.     

Liver and pancreas transplantation in Europe--and in Hungary.

Liver transplantation (LT) is the sole treatment modality of most of diffuse liver diseases. Simultaneous-pancreas-kidney (SPK) transplantation is also a life saving operation for IDDM patients. Both procedures are established treatment options in the European Community (EC) and in the US. These procedures are performed in a significantly smaller number in Hungary. Having a larger demand for LT than the supply of cadaver donors alternative solutions are sought to increase the number of transplantable livers. In Hungary partly the shortage of donors and the shortage of recipients are the factors rendering the number of LTs and SPKs low. These factors can be changed by better organisation and good survival data that make the two procedures accepted by the community of physicians.