La transplantation pancréatique

Pancreas transplantation is one of the possible therapeutic approaches in type 1 diabetes (T1D). Expected benefits must outweigh the potentially severe complications which can be related to the surgical procedure and to long-term immunosuppressive therapy, and decision must be taken by an experienced multidisciplinary team. The most frequent indication is simultaneous pancreas-kidney transplantation in a patient with T1D and severe diabetic nephropathy, either on dialysis or, preferably, before end-stage renal disease (pre-emptive transplantation). But pancreas transplantation alone should also be considered in patients with brittle diabetes endangering vital prognosis through acute metabolic complications and responsible for poor quality of life.