Benefits of Pancreas Transplant Last for Years in Diabetics
WebMD News Archive
September 13, 1999 (Montreal) -- The benefits of pancreas transplantation in a group of type 1 diabetics have lasted 18 years thus far, according to research published in the September issue of Diabetes. Fifteen out of 16 patients reported that their quality of life improved after they underwent the controversial procedure.
The results are good news for diabetic patients, says Richard A. Dickey, MD, who reviewed the study for WebMD. "Any young person who has a good outlook in terms of their long-term quality of life and productivity could be considered for transplantation," he says. "The important thing is to explain the risks and the benefits, and I do that every week to patients," says Dickey, who is president of the American Association of Clinical Endocrinologists. But he adds that pancreatic transplantation is still a very risky procedure that can be fatal.
Diabetes is associated with abnormally high blood sugar levels due to a lack of insulin, which is required for the body to absorb, burn, and store sugar, or glucose, in the bloodstream. In type 1 diabetics, abnormalities of the pancreas make the organ unable to produce insulin. Without pancreas transplantation, patients with type 1 diabetes must get daily insulin injections in order to survive. Successful transplantation also reduces the likelihood of complications from diabetes, which can affect virtually every organ in the body.
"The question has always been, ... just how long is [transplantation] going to work? ... In some people, as the current article points out, you can carry a successful pancreas transplant almost 20 years. ... It doesn't say that everyone's going to have a successful transplant for 20 years, but there are people who have been able to carry that off," says the lead author of the study, R. Paul Robertson, MD. Robertson is CEO/scientific director of the Pacific Northwest Research Institute and an affiliate professor of pharmacology at the University of Washington in Seattle.
The investigators recruited 16 patients, aged 33 to 54, who had had type 1 diabetes for 13 to 30 years and had received a total or partial pancreas transplant 10 to 18 years ago. Twelve patients had also undergone kidney transplantation before, with, or after their pancreas transplantation because their diabetes had caused their kidneys to fail. All patients were taking medication to suppress their immune systems so they would not reject their transplanted pancreases, but none needed to take insulin or other drugs that lower the amount of glucose in the bloodstream.
The subjects underwent several tests to assess their glucose and insulin blood levels as well as their body's ability to produce insulin when required. For the most part, their test results were similar to those of healthy individuals. Fifteen of the 16 patients told investigators that their quality of life had improved after pancreatic transplantation. The remaining patient explained that the adverse cosmetic side effects of prednisone, used to suppress the immune system and decrease transplant rejection, offset the benefit of the transplant.
"Patients should know that not every doctor knows about this," co-author David E. R. Sutherland tells WebMD. Sutherland is professor of surgery and director of the transplant patient program at the University of Minnesota in Minneapolis.
"Many doctors are really thinking about pancreas transplantation the way they were done 20, 30 years ago, and it's changed a lot. ... [Patients] should know that they can do it if they want to," Sutherland says.
This research received funding from the National Institutes of Health and the Pacific Northwest Research Institute.