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Combined ‘En Bloc’ Liver and Pancreas Transplantation in Patients with Liver Disease and Type 1 Diabetes Mellitus
Author(s) -
Pirenne Jacques,
Deloose Koen,
Coosemans Willy,
Aerts Raymond,
Van Gelder Frank,
Kuypers Dirk,
Maes Bart,
Verslype Chris,
Yap Paul,
Van Steenbergen Werner,
Roskams Tania,
Mathieu Chantal,
Fevery Johan,
Nevens Frederik
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00588.x
Subject(s) - medicine , liver transplantation , diabetes mellitus , pancreas transplantation , liver disease , gastroenterology , pancreas , transplantation , type 1 diabetes , chronic liver disease , type 2 diabetes mellitus , disease , type 2 diabetes , endocrinology , cirrhosis , kidney transplantation
Liver disease alters the glucose metabolism and may cause diabetes, but this condition is potentially reversible with liver transplantation (LTx). Type 1 diabetes mellitus may be coincidentally present in a LTx candidate and immunosuppressive drugs will aggravate diabetes and make its management more difficult for posttransplant. In addition, diabetes negatively influences outcome after LTx. Therefore, the question arises as to why not transplanting the pancreas in addition to the liver in selected patients suffering from both liver disease and Type 1 diabetes. We report two cases of en bloc combined liver and pancreatic transplantation, a technique originally described a decade ago in the treatment of upper abdominal malignancies but rarely used for the treatment of combined liver disease and Type 1 diabetes. Both recipients are currently liver disease‐free and insulin‐free more than 2 and 4 years posttransplant, respectively. Surgical, medical and immunological aspects of combined liver‐pancreas transplantation are discussed in the light of the existing relevant literature.