From the Guidelines
Recent studies have significantly impacted clinical practice in pancreas transplantation, with a focus on improving graft survival, optimizing immunosuppression, and enhancing patient selection and post-transplant monitoring. The most recent and highest quality study, published in 2025 in the journal Diabetes Care 1, highlights the importance of pancreas transplantation in normalizing glucose levels and mitigating microvascular complications of type 1 diabetes, while also emphasizing the need for lifelong immunosuppression to prevent graft rejection. Some key points from recent studies include:
- The potential benefits of pancreas transplantation for people with type 1 diabetes undergoing simultaneous kidney transplantation, following kidney transplantation, or for those with recurrent ketoacidosis or severe hypoglycemia despite optimized glycemic management 1.
- The regulation of allogenic islet transplantation as an organ transplant in much of the world, and as a cell therapy in the U.S., with the approval of donislecel-jujn in 2023 for the treatment of adults with type 1 diabetes who are unable to reach their A1C goals due to repeated episodes of severe hypoglycemia 1.
- The investigation of alternative islet sources, which may provide new options for patients with type 1 diabetes 1.
- The importance of considering the potential adverse effects of immunosuppressive therapy when deciding on pancreas transplantation, and reserving it for patients who will benefit most from the treatment 1. Overall, the current evidence suggests that pancreas transplantation should be reserved for specific patient populations, and that ongoing research is needed to improve graft survival, optimize immunosuppression, and enhance patient outcomes.
From the Research
Recent Articles on Pancreas Transplantation
- The article "Ex situ Perfusion of Pancreas for Whole-Organ Transplantation: Is it Safe and Feasible? A Systematic Review" 2 published in 2020 discusses the feasibility of ex situ perfusion of pancreas for whole-organ transplantation, highlighting its potential to reduce ischemic reperfusion injuries.
- The study "Long-term benefits of pancreas transplantation" 3 published in 2008 focuses on the long-term benefits of pancreas transplantation, including improved mortality rates, diabetic nephropathy, and retinopathy.
- The case report "Conversion from tacrolimus to belatacept to prevent the progression of chronic kidney disease in pancreas transplantation: case report of two patients" 4 published in 2014 explores the use of belatacept as an alternative to calcineurin inhibitors in immunosuppression regimens for pancreas transplant patients.
- The article "Pancreas Transplantation: Indications, Techniques, and Outcomes" 5 published in 2019 provides an overview of pancreas transplantation, including indications, techniques, and outcomes, highlighting the importance of careful donor and recipient selection for good outcomes.
Key Findings
- Ex situ perfusion of pancreas for whole-organ transplantation is feasible and may reduce ischemic reperfusion injuries 2.
- Pancreas transplantation has long-term benefits, including improved mortality rates and diabetic complications 3.
- Belatacept may be a viable alternative to calcineurin inhibitors in immunosuppression regimens for pancreas transplant patients 4.
- Careful donor and recipient selection is crucial for good outcomes in pancreas transplantation 5.