Indications and results of pancreatic transplantation: the Oslo experience 1983-1990.

The Norwegian pancreas transplantation programme was initiated in June 1983. By November 1990, a total of 77 pancreatic transplantations had been performed, 63 simultaneously with a renal transplant. Five patients received pancreatic grafts after previous renal grafting while nine non-uraemic diabetic patients received pancreatic grafts only. In April 1988, the surgical technique was changed from duct-occluded segmental pancreas to whole pancreas grafting with duodenocystostomy. In recipients of combined grafts from the first group (segmental pancreatic grafts), the 1- and 5-year survival rates were 96% and 90% for the patients, 84% and 69% for renal grafts and 66% and 45% for pancreatic grafts. In the second group (whole pancreatic grafts with duodenocystostomy), the 6-month and 2-year survival rates were 87% at both intervals for the patients, 87% and 75% for both grafts. However, even though the bladder drainage technique allows isolated pancreas graft rejection to be diagnosed, the results of isolated pancreas grafting were not improved by this technique, and most of these grafts were lost in therapy-resistant graft rejection.