Pancreas and Islet Transplantation

DEFINITION

• Pancreas transplant (PTx) refers to allo-transplantation (human to human) of the whole pancreas, including islets of Langerhans, acinar tissue, pancreatic ducts and blood vessels. The donor may be a deceased cadavaric donor, or a partial organ from a living donor.
  • Pancreas transplant can be performed as pancreas transplant alone (PTA), in which a pancreas is transplanted into a patient with no need for a kidney transplant; simultaneous pancreas and kidney (SPK) transplant, in which both a pancreas and a kidney are transplanted during the same operation; or pancreas after kidney (PAK) transplant, in which a patient receives a pancreas transplant after previously having received a kidney transplant in a separate operation
• Pancreatic islet transplant refers to a procedure in which only the islets of Langerhans, which contain the endocrine cells of the pancreas, including the insulin producing beta cells and glucagon producing alpha cells, are isolated and transplanted into a patient.
  • Islet cell transplant can be performed in 2 settings: allotransplantation in which islets of Langerhans are isolated from one or more cadaveric donor pancreases, and infused into the portal vein of a recipient; or autotranplantation, in which islets of Langerhans are isolated from the pancreas of a patient undergoing pancreatectomy for pancreatitis, and returned to the patient via infusion into the portal vein.
  • As with whole organ transplant, islet allotransplantation can be perform as islet-transplant alone (ITA), islet-after-kidney (IAK), or as islet simultaneous with kidney (SIK).