Evaluation of pancreatic transplantation cases performed at Akdeniz University Medical Faculty

Diabetes is the most common cause of renal failure. Although dialysis and insulin therapies prevent the short term death, these therapies are inadequate for long term complications in patients with Type 1 diabetes and end stage renal failure. Pancreas transplantation is the only treatment for type I diabetes mellitus that can induce an insulin-independent normoglycemic state. A total of 77 patients who had pancreas transplantation in Akdeniz University Faculty of Medicine Department between February 2003 and May 2016 were included in the study. Patients files were analysed retrospectively. We computed graft and patient survival rates according to the Kaplan-Meier method and used uni- and multivariate analyses.All data evaluated with SPSS ver.19 programme. P < 0.05 was considered statistically significant. Of all the cases, 50 (64.9.2%) were in the PAK group, 26 (33.8%) in the SPK group, and 1 (1.3 %) were in the PTA group. There were 55 males and 22 females in the all group. Median (min–max) recipient and donor ages in the groups were 33 (22-50), 25 (12-52) years, respectively. Mean (SD) duration of diabetes was 21.1 (5.6) years in all patients. The exocrine drainage was done as bladder exocrine drainage in 18 and as enteric exocrine drainage in 59 patients. Acute pan-creatic rejection was observed in 12 patients in the SPK group and 29 patients in the PAK group (p=0.34). In addition, nineteen pancreas graft were lost due to chronic rejection. The median follow-up duration for all patients was 149.96 ± 5.23 months. At the end of the 1-year and 5-year fol¬low-up, the patient and pancreas survival rates in the SPK group were 100 %, 95 % and 81 %, 55 % respectively, and the corresponding values in the PAK group were 100 %, 98 % and 62%, 46 %. Patient survival rates were higher in SPK when compared with PAK patients, but not statistically significant (p=0.246). On the other hand, graft survival rates were higher in SPK when compared with PAK patients, and statistically significant (p=0.020). In conclusion, pancreatic transplantation is growing and has quickly become the gold standard of care for patients with type 1 diabetes mellitus and renal failure. Pancreas transplantation offers a better quality of life and longer survival for patients with diabetes mellitus. However, the number of transplants in our country is gradually decreasing. This issue should be given importance, endocrinologist and surgeons should be encouraged.