Interest in transplantation of the pancreas appeared after the experiments of physiologists from Strasbourg Mering and Minkowski, who in 1890. have shown that removal of the pancreas leads to diabetes.
Insulin-dependent diabetes is widely distributed throughout the world. The use of insulin has significantly prolong the lives of people with diabetes by preventing acute complications of the disease, but did not solve the problem of damage to the nervous system, kidneys, blood vessels with subsequent development of retinopathy and blindness, and many other complications. Despite the mortality, the disease, in contrast to diseases of the heart and liver, does not require quick decisions. However, it must carefully weigh the benefits of surgery with the risk of technical and medical complications.
The indications for transplantation are the problems of metabolic control: resistance to subcutaneous insulin, for labile disease with a tendency to develop hyper-and hypoglycemic states, as well as a combination of endocrine and exocrine pancreatic insufficiency.
Contraindication for surgery - the presence of malignant tumors, foci of purulent infection, mental illness, severe cardiovascular failure.
All potential donors are cadaveric kidneys can be considered as a donor pancreas, except for those in the past suffered from diabetes, chronic pancreatitis or pancreatic injury had a history. In most cases, the removal of the pancreas from cadaveric donors is part of multiorgan fence after removing the heart and liver.
Preoperative examination of the patient shall consist of a general and biochemical blood tests and urine tests to determine the level of calcium and other electrolytes, blood, and various instrumental examinations. All the complications of diabetes should be carefully evaluated related professionals - ophthalmologist, neurologist and others. Immunological study includes the determination of blood group, tissue typing. Considered minimally acceptable match the blood type.
Technique of the operation itself to date with respect to reliable and standardized.
In the postoperative period than conventional activities, special attention is paid to prevention of thrombosis and infection, immunosuppression, and conducting surveillance of the graft. To assess the state of the transplanted pancreas determine the concentration of glucose in the blood level of amylase in blood and urine.
Usually, the normalization of blood glucose levels occur several hours after transplantation. There is a significant improvement in quality of life in all its components - is social, physical and psychological rehabilitation.