Pancreas transplant alone (PTA) may be a viable option for fragile individuals with uncontrolled diabetes due to its promising outcomes….
Unlike an individual on an insulin regimen, individuals with a pancreas transplant can bring their blood glucose levels to a normal level without the risk of hypoglycemia. A transplant is also more likely to prevent or stop the progression of complications associated with diabetes.
In a study involving the International Pancreas Transplant Registry, a little less than 2,000 pancreas transplant alone cases were reviewed from the year 1966 to 2011. Using the Kaplan-Meier method and uni and multivariate analyses, patient and graft survival rates were calculated as a measure of transplant success.
In more recent years, between 2007 and 2011, patient survival rates generally increased with "more than 95% at 1 year post transplant and more than 90% at 5 years." In regards to graft survival rates, patients on a tacrolimus based maintenance therapy had an 86% survival rate after their first year and a 69% rate at 3 years. Those who were on a sirolimus based maintenance therapy had slightly higher graft survival rates, with 94% during their first year and 84% during their second year.
According to the study researchers, these rates have progressively gotten better due to the decline in "technical and immunologic graft failure rates." Improved outcomes have also decreased the need for kidney transplants.
In conclusion, pancreas transplant alone is now considered a "highly successful long-term option" for patients with "brittle diabetes and recurrent episodes of hypoglycemia and/or hypoglycemic unawareness."
Gruessner RWG, Gruessner AC. Pancreas Transplant Alone: A Procedure Coming of Age. Diabetes Care. 2013;36(8):2440-2447.