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Pancreas tranplantation
- Question
- Because of the important part of pancreas in the disease, why do not transplant this organ?
- Answer
- Dear questioner
The transplantation of one organ is considered when the vital prognosis is engaged by the failure of this organ as it is the case for lung, heart and liver transplantation, or in case of very heavy treatment and risk of complication as it is the case for kidney transplantation. Indeed, the transplantation risk (surgical and during intensive care risk, risk of rejection, risk of infection…) are compared with the initial disease risk. Of course, the pancreas is ill in cystic fibrosis but it is possible to correct his role by medicine. The advantage/risk scales of isolated pancreas transplantation is not in favor of transplantation.
The role of pancreas is double :
- Exocrine function which is secretion of enzymes in bowel. This function is corrected by enzymes taken by capsule at the beginning of meal.
- endocrine function which is secretion of insulin by islets of Langerhans to regulate blood sugar level.
However, pancreas transplantation could be performed in diabetic cystic fibrosis patient when another transplantation is indicated : double graft lung-pancreas, liver-pancreas or kidney-pancreas. It is the same donor for the two organs.
There are two types of pancreas transplantation :
- the pancreas graft which corrects both exocrine and endocrine functions but the complication of surgery are important and restrict the indication of this transplantation.
- the islets graft which is currently in evaluation by protocol. This graft does not correct exocrine function. The transplantation is performed with the same donor a few days after the first transplantation following a laboratory preparation of islets cells. This graft does not require surgery and is performed by injection under local anesthesia. The complications are lower but insulin secretion is not totally corrected and insulin injections continue to be necessary but with reduced dosage
Sincerely yours
Dr Isabelle Danner-Boucher
- 24.03.2011
