Hyperglycemia is an important factor in the development and progression of the complications of diabetes. Pancreas
transplantation is currently the only method able to achieve sustained normoglycemia in type I diabetes. By now,
this procedure has become an accepted treatment option combined with kidney transplantation for selected patients
with end-stage diabetic nephropathy. The definite benefits of pancreas transplantation comprise relieve from insulin
administration, superb glycemic control, improved quality of life and long-term survival of patient with severe
autonomic neuropathy. Presumed benefits represent stabilization or slowing of progression of microvascular
complications. Definite disadvantages are the risk of the surgical procedure, graft rejection and the necessity of
permanent immunosuppression. Isolated pancreas transplantation in nonuremic type-1 diabetic patients is still
controversial. Diabetic complications of the potential recipient have to be potentially correctable by the transplantation
and their significance must exceed all risks of the operation and life-long immunosuppression. Currently, approx.
25 combined transplants are performed per year in IKEM with the results comparable to those reported by the
International Pancreas Transplant Registry. Seven nonuremic type-1 diabetic recipients of 8 operated in IKEM by
June 2000 have been insulin-independent for 1–33 months. The main indication for isolated pancreas transplantation
is brittle diabetes with hypoglycemia unawareness syndrome and labile diabetes with severe autonomic neuropathy
and rapid progression of microangiopathy despite appropriate intensified insulin therapy.?
diabetes mellitus, pancreas transplantation, diabetic nephropathy, microangiopathy.