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Indications for Transplant

                                               Kidney/Pancreas and Islet Transplantation: Version 7.0

Indications for Kidney/Pancreas Transplantation (SPK and PAK)

Since kidney/pancreas and pancreas transplantation are the only known treatments that can restore euglycemic in Type I diabetics and slow the progression of diabetic complications, pancreas transplantation is indicated in all patients in whom the risks of transplantation and of chronic immunosuppression are less than the risk of continued diabetic complications.  

Indications for Pancreas Transplantation Alone (PTA)

The principal indication for PTA is uncontrolled/brittle diabetes in a patient with Type I diabetes who does not have kidney failure. This is typically a younger person who has not been diabetic long enough to develop significant kidney disease.  These patients will have difficultly controlling diabetes, demonstrated by frequent episodes of hypoglycemia severe enough to require medical attention and hypoglycemic unawareness. These patients should demonstrate that they are compliant with a strict control regimen, and that in spite of their efforts, the dosage of exogenous insulin sufficient to control their diabetes produces frequent hypoglycemia. Hypoglycemic unawareness is a particular concern. In these patients, the benefits of enhanced glycemic control and freedom from hypoglycemic episodes needs to outweigh the risks of the procedure and chronic immunosuppression.