Ann Surg Treat Res.
2025 May;108(5):271-278. 10.4174/astr.2025.108.5.271.
Outcomes of pancreas transplantation over two decades: a single-center retrospective cohort study
- Affiliations
-
- 1Division of Vascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- 2Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
- 3Department of Surgery, Chung-Ang University Hospital, Seoul, Korea
- 4Division of Transplantation and Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2567827
- DOI: http://doi.org/10.4174/astr.2025.108.5.271
Abstract
- Purpose
Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival.
Methods
A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death.
Results
Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045).
Conclusion
PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.
