Long-term prognosis of 65 patients with indication for pancreas transplantation

The use of pancreatic transplantation from heart-beating donors began in Japan in 2000; however, the longterm prognoses of patients undergoing this procedure have not been fully investigated. We evaluated the survival rates, complications and quality of life (QOL) in 65 patients with indications for pancreatic transplantation. No deaths occurred in the 25 transplanted patients (median follow-up period: 8.0 years), whereas the 5-year survival rate was 85 % in the 40 patients waiting for transplantation (p = 0.0004). The cause of death was sudden death in half of the patients who died. The 5-year withdrawal rate of insulin was 73 %, while that of dialysis in 23 simultaneous pancreas-kidney transplantation recipients was 92 %. The event-free rates in the patients with macrovascular diseases tended to be higher among the transplanted patients (p = 0.091), while those in the patients with cancer or bone fractures did not differ between the two groups. In contrast, infectious diseases requiring hospitalization developed more often in the transplanted patients than in the patients waiting for transplantation (5-year rate: 53 %, p = 0.0008). The QOL in the transplanted patients with functioning grafts remained to be improved, while the patients with non-functioning grafts exhibited a worsening QOL. The present study demonstrated that pancreatic transplantation markedly improves the survival rate in patients with type 1 diabetes mellitus.