ABSTRACT
Total pancreatectomy may be the only treatment option that relieves pain and tissue destruction for patients with chronic pancreatitis, but this procedure causes surgically induced diabetes, which is difficult to manage because of the absence of insulin-producing beta cells. Some patients may benefit from autologous islet cell reimplantation, a procedure that involves collecting and purifying the islets of Langerhans from the patient's own resected pancreas and reinfusing them into the patient via the portal vein. Typically, candidates for this procedure are younger adults with nondilated pancreatitis that has yet to develop into glucose intolerance. Islet cell transplantation success varies and is directly related to the quality and quantity of the patient's pancreas and the damage caused by the chronic pancreatitis.
Subject(s)
Diabetes Mellitus/etiology , Diabetes Mellitus/prevention & control , Islets of Langerhans Transplantation/methods , Islets of Langerhans Transplantation/nursing , Pancreatectomy/adverse effects , Humans , Pancreatectomy/nursing , Pancreatitis, Chronic/surgery , Patient Education as Topic , Transplantation, AutologousSubject(s)
Congresses as Topic , Islets of Langerhans Transplantation/nursing , Societies, Nursing/organization & administration , Clinical Trials, Phase I as Topic/methods , Clinical Trials, Phase I as Topic/nursing , Diabetes Complications , Diabetes Mellitus/therapy , Humans , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/therapyABSTRACT
Statistically 3 out of 4 patients with diabetes mellitus die from the secondary effects of the disease. Approximately 30%-40% of patients with end stage renal disease (ESRD) have diabetes. Simultaneous kidney/islet cell transplantation offers an innovative approach to the treatment of these chronic and disabling illnesses. Nursing care priorities are directed at maintaining central venous access and normoglycemia. Prescribed nursing care protocols require specialized postoperative assessments, interventions, and intensive patient education. These protocols have been developed in order to foster islet cell graft revascularization and ultimately to eliminate exogenous insulin requirements and regression of secondary complications of diabetes.
