RESUMO
INTRODUCTION: Diabetes mellitus is a spectrum of diseases characterized by the absence of glycemic control and the development of secondary complications. Type 1 diabetes (insulin-dependent) accounts for a minority of cases, but it usually presents in younger age groups. This disease significantly affects quality of life. METHODS: We retrospectively reviewed the cases of pancreas transplantation performed at University of Texas, Houston, from February 2008 to August 2009. All patients received immunosuppression induction with thymoglobulin (1.5 mg/kg). We used 3 drugs for maintenance: tacrolimus, mycophenolic acid, and prednisone. All patients received cytomegalovirus prophylaxis. RESULTS: We transplanted 54 organs in 29 patients with type 1 diabetes mellitus. The mean patient age was 42 years. Patients had diabetes mellitus type 1 for an average of 28.82 years and were on dialysis for an average of 2 years. Nineteen patients were male (65%). Complications ensued in 68% of cases (20 patients), 9 of which required surgical exploration (31%). We lost 3 pancreatic allografts. DISCUSSION: Pancreas transplant recipients constitute a unique population with a high risk of complications in the acute setting. During the first 3 months after simultaneous pancreas-kidney transplantation the relative mortality risk is increased but after a year it has clear advantage over diabetic patients on dialysis waiting for a transplant. To date, 26 patients have functional pancreatic allografts and 29 are dialysis-free. Pancreas transplantation is a challenging procedure. Surgeons must be prepared to aggressively manage the possible complications.
